On the Relationship Between Meniere's Disease and Endolymphatic Hydrops
On the Relationship Between Meniere's Disease and Endolymphatic Hydrops
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论梅尼埃病与内淋巴积水的关系
DOI：
10.1097/mao.0000000000002502
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发表时间：
2020-02-01
影响因子：
2.1
通讯作者：
Gluth, Michael B.
中科院分区：
文献类型：
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作者：
Gluth, Michael B.
梅尼埃病和内淋巴积水之间的关系尚不明确。一方面，缺乏梅尼埃病的典型症状的内淋巴积水病例的存在促使断言单独的内淋巴积水不足以引起症状，并驱动内淋巴积水仅仅是副现象的假设。然而，另一方面，有相当多的证据表明，内淋巴积水的机械压力效应与由此导致的听觉生理学和听觉功能障碍之间存在关系。一个关键的评估这一主题进行，包括审查主要负责的附带现象假说的关键组织病理学数据。总体而言，A）现有证据的优势表明，内淋巴积水可能是梅尼埃病的一些听觉症状的原因，特别是那些可以通过机械操作基底膜和耳蜗颤噪来调节的症状; B）梅尼埃病可以合理地被认为是更大范围的积水性内耳疾病的一部分，该疾病还包括一些没有眩晕的病例。C）与内淋巴积水的关系足够稳健，以将其存在视为梅尼埃病的标志性定义特征和诊断检测的敏感目标。
The relationship between Meniere's disease and endolymphatic hydrops is ambiguous. On the one hand, the existence of cases of endolymphatic hydrops lacking the classic symptoms of Meniere's disease has prompted the assertion that endolymphatic hydrops alone is insufficient to cause symptoms and drives the hypothesis that endolymphatic hydrops is a mere epiphenomenon. Yet, on the other hand, there is considerable evidence suggesting a relationship between the mechanical pressure effects of endolymphatic hydrops and resultant disordered auditory physiology and symptomatology. A critical appraisal of this topic is undertaken, including a review of key histopathologic data chiefly responsible for the epiphenomenon hypothesis. Overall, a case is made that A) the preponderance of available evidence suggests endolymphatic hydrops is likely responsible for some of the auditory symptoms of Meniere's disease, particularly those that can be modulated by mechanical manipulation of the basilar membrane and cochlear microphonic; B) Meniere's disease can be reasonably considered part of a larger spectrum of hydropic inner ear disease that also includes some cases that lack vertigo. C) The relationship with endolymphatic hydrops sufficiently robust to consider its presence a hallmark defining feature of Meniere's disease and a sensible target for diagnostic detection.