Ménière’s Disease

214 Pages·1990·5.71 MB·English

by  Masaaki Kitahara (auth.)

M. Kitahara
(Ed.)
Meniere's
Disease
With 101 Illustrations
Springer-Verlag
Tokyo Berlin Heidelberg
New York London Paris
Hong Kong Barcelona
Masaaki Kitahara, M.D.
Director, The Vestibular Disorder Research Committee
Professor and Head, Department of Otolaryngology, Shiga University of Medical Science,
Seta, Otsu, 520-21 Japan
ISBN-13: 978-4-431-68113-7 e-ISBN-13: 978-4-431-68111-3
001: 10.1007/978-4-431-68111-3
Library of Congress Cataloging-in-Publication Data
Meniere's disease / M. Kitahara (ed.). p. cm. Includes bibliographical references. Includes index.
I. Meniere's disease.
I. Kitahara, Masaaki. [DNLM: I. Meniere's Disease- diagnosis. 2. Meniere's Disease
physiopathology. 3. Meniere's Disease- therapy. WV 258 M5452] RF275.M441990 617.8'82-dc20
DNLM/DLC 90-10153
© Springer-Verlag Tokyo 1990
Softcover reprint of the hardcover 15t edition 1990
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Preface
Meniere's disease is often a wastebasket diagnosis for conditions of dizziness of
unknown origin. To guide physicians in making a diagnosis, it would be desirable
for this ailment to have a common base for management as many other specific
diseases have. Meniere's is certainly a disease with unknown etiology, and it is quite
difficult to determine its origin, a fact recognized by all investigators in the world,
without exception. However, there is no excuse for the fact that this ailment is still
a dumping ground for dizziness which cannot be neatly associated with something
else. It is too easy to state that the complete story was given by Meniere himself,
his description has never been improved upon, and everything is still speculative
until we acquire more knowledge. For an intractable ailment such as Meniere's
disease, however, it is probable that an endless chain of unknown etiologies will
continue even though occasional origins are confirmed in some cases. Therefore,
our knowledge must be constantly updated in order that physicians may obtain the
greatest benefit from it. When the picture of Meniere's disease becomes clearer
through this compilation, the investigations of the etiology of this ailment will
continue in the right direction.
The Ministry of Health and Welfare of Japan designated as "intractable" 43
diseases of which the etiology is unknown and for which definitive treatment
methods are not yet established. For each of these diseases, a research committee
was organized and intensive investigations are being carried out with the aid of
grants from the Ministry. The Vestibular Disorder Research Committee, formerly
known as the Meniere's Disease Research Committee, has designed and proceeded
with research on Meniere's disease, which was designated "intractable" in 1974.
The present volume consists of recent studies resulting from the activities of our
committee. It is my wish that this volume will help promote interest in the problems
of Meniere's disease and encourage those physicians who have been confronted
with this difficult ailment.
The encouragement and help I have received in the achievement of the study and
publication of this volume comes from too many sources to mention here. However,
I would especially like to express my heartfelt appreciation and gratitude to Pro
fessor Emeritus of Osaka University, Toshi Naito, M.D., Professor Emeritus of
Tokyo Medical and Dental University, Isamu Watanabe, M.D., and Former Pro
fessor of Kyoto University, Manabi Hinoki, M.D., for their enthusiastic help and
VI Preface
advice in our research of Meniere's disease. Dr. T. Naito is a disciple of Professor
Emeritus of Osaka University, Kyoshiro Yamakawa, M.D., who first revealed the
pathological findings of Meniere's disease in 1938, and of Professor George Port
mann, M.D., who invented endolymphatic sac drainage surgery for Meniere's
disease in 1927. Dr. J.J. Shea recognized Naito's leadership in Laryngoscope
(89: 1244-1256, 1979). Dr. T. Naito first created endolymphatic hydrops in guinea
pigs by the obliteration of the endolymphatic sac and by other techniques in 1950.
He also invented subarachnoid drainage surgery for Meniere's disease together with
Dr. K. Yamakawa in 1952. Dr. T. Naito is indeed a pioneer of Meniere's disease
study. Dr. I. Watanabe and Dr. M. Hinoki were directors of the Meniere's Disease
Research Committee (1974-1979) and the Vestibul~r Disorder Research Commit
tee (1980-1985), respectively. They have influenced the development of Meniere's
disease research in Japan and made special efforts to establish its current stature. I
am also deeply grateful to our committee members for their cooperation in our
research project and to the Disease Control Division of the Health Service Bureau,
the Ministry of Health and Welfare, Japan, for its enormous service in promoting
our activities.
M asaaki Kitahara
Contents
Preface.... ...................... .......................... V
List of Contributors .......................................... XI
Part I. Introduction
1. Concepts and Diagnostic Criteria of Meniere's Disease
M. Kitahara ............................................. 3
2. Meniere's Disease with Bilateral Fluctuating Hearing Loss
M. Kitahara, H. Kitano, and M. Suzuki ........................ 13
Part II. Pathophysiology of Meniere's Disease
3. The Physical Strength of the Membranous Labyrinth and Its Relation to
Endolymphatic Hydrops
T. Ishii, N. Yamamoto, and T. Machida ........................ 23
4. Blood-Flow Regulation in the Vestibulum and Inner Ear Microvascula
ture in Experimental Hydrops: A Scanning Electron Microscopic Study
Y. Nakai, H. Masutani, M. Sugita, M. Moriguchi, and K. Matsunaga 35
5. Electrophysiological Aspects of Surgically-Induced Endolymphatic
Hydrops
J. Kusakari, Z. Ito, N. Nishikawa, M. Takeyama, Y. Furuhashi, A. Hara,
T. Kawase, K. Ohyama, T. Kobayashi, E. Arakawa, and M. Rokugo 45
6. The Developmental Pattern of Experimental Hydrops in the Endolym
phatic Space
Y. Yazawa .............................................. 57
VIII Contents
7. An Animal Model: Meniere's Disease Attack
K. Uchida and M. Kitahara ................................. 65
8. An Experimental Study on the Mechanism of the Meniere's Attack:
The Influence of High Perilymphatic Potassium Concentration on the
Vestibular System
J. Hozawa, K. Fukuoka, K.lkeno, E. Fukushi, and K. Hozawa ....... 73
9. A Pathohistological Study with Four Kinds of Stress Stimulations on
Active Endolymphatic Hydrops in Guinea Pigs
o.
K. Akioka, Y. Kitaoku, Tanaka, and T. Matsunaga ............. 81
10. The Effect of Steroids on Endolymphatic Hydrops Induced by an Immu
nological Technique
Y. Yazawa, M. Kitahara, K. Uchida, and I. Sawada ............... 87
11. A Pathoanatomical Study of the Endolymphatic Sac in Meniere's
Disease
Y. Yazawa and M. Kitahara ................................. 93
12. Labyrinthine Anomaly and Endolymphatic Hydrops
H. Saito, T. Takeda, S. Kishimoto, and M. Furuta ................ 101
13. An Anatomical Study on Cadavers with a History of Dizziness: Tempor
al Bone and Some Arteries, Nerve Roots, and Nuclei Related to the
Internal Ear
o. Tanaka, H. Shinohara, and H. Otani ........................ 107
Part III. Symptomatology and Diagnosis of Meniere's Disease
14. A Statistical Study on Patients with Meniere's Disease Visiting Our
Clinic During the Past 10 Years
Y. Wada, I. Koh, K. Akioka, N. Fujita, T. Matsunaga, and H. Iwasaki 115
15. Prediction of Prognosis for Hearing in Meniere's Disease
K. Mizukoshi, S. Aso, and Y. Watanabe ........................ 121
16. A Clinical Study of the Diagnosis of the Endolymphatic Hydrops Aspect
of Meniere's Disease
K. Akioka, N. Fujita, Y. Kitaoku, and T. Matsunaga .............. 125
17. The Significance of the Furosemide VOR Test for Meniere's Disease
K. Mizukoshi, Y. Watanabe, H. Kobayashi, and H. Shojaku ......... 133
18. Pathogenesis of the Broad Waveform in Electrocochleograms
T. Takeda, H. Saito, I. Sawada, and M. Kitahara ....... . . . . . . . . .. 139
Contents IX
19. A Test for Predicting the Next Episode in Meniere's Disease
J. Hozawa, F. Fujiwara, and T. Kamimura ...................... 147
20. The Clinical Epidemiology of Meniere's Disease: Functional Asymmetry
l. Watanabe, M.lkeda, and Y. Niizeki ......................... 153
21. The Contribution of Otolaryngologists in the Diagnosis of Neuro
Otological Disease: Acoustic Neuromas
M. Kitahara, H. Kitano, H. Tanaka, and J. Handa. . . . . . . . . . . . . . .. 159
Part IV. Treatment of Meniere's Disease
22. The Treatment of Meniere's Disease with Isosorbide
H. Kitano and M. Kitahara ................................. 165
23. Transderma1 Scopolamine in the Treatment of Vertiginous Episodes
Associated with Meniere's Disease
T. Kumoi, T. Inamori, and H. Mori ........................... 173
24. The Status of Endolymphatic Sac Surgery
M. Kitahara ............................................ 181
Part V. Other Diseases with Endolymphatic Hydrops
25. Endolymphatic Hydrops Induced by Chronic Otitis Media
E. Yamamoto and C. Mizukami .............................. 191
26. Sudden Deafness with Bilateral Endolymphatic Hydrops
M. Suzuki and M. Kitahara ................................. 199
27. Secondary or Idiopathic Endolymphatic Hydrops?
M. Kitahara and Y. Yazawa ................................. 211
Index ..................................................... 217
List of Contributors
K. Akioka, M.D.,
Department of Otolaryngology, Nara Medical College, Shijo-cho, Kashihara, 634
Japan
E. Arakawa, M.D.,
Department of Otolaryngology, Tohoku University School of Medicine, Seiryo
cho, Sendai, 980 Japan
S. Aso, M.D.,
Department of Otolaryngology, Faculty of Medicine, Toyama Medical and Phar
maceutical University, Sugitani, Toyama, 930-01 Japan
N. Fujita, M.D.,
Department of Otolaryngology, Nara Medical College, Shijo-cho, Kashihara, 634
Japan
F. Fujiwara, M.D.,
Department of Otolaryngology, Hirosaki University School of Medicine, Zaifu
cho, Hirosaki, 036 Japan
K. Fukuoka, M.D.,
Department of Otolaryngology, Hirosaki University School of Medicine, Zaifu
cho, Hirosaki, 036 Japan
E. Fukushi, M.D.,
Department of Otolaryngology, Hirosaki University School of Medicine, Zaifu
cho, Hirosaki, 036 Japan
Y. Furuhashi, M.D.,
Department of Otolaryngology, University of Tsukuba Institute of Clinical Medi
cine, Tennodai, Tsukuba, 305 Japan
M. Furuta, M.D.,
Department of Pathology, Kyoto Takeda Hospital, Shimogyo, Kyoto, 606
Japan
A. Hara, M.D.,
Department of Otolaryngology, Tsukuba University Institute of Clinical Medicine,
Tennodai, Tsukuba, 305 Japan
XII List of Contributors
J. Handa, M.D.,
Professor, Department of Neurosurgery, Shiga University of Medical Science, Seta,
Otsu, 520-21 Japan
J. Hozawa, M.D.,
Professor, Department of Otolaryngology, Hirosaki University School of Medi
cine, Zaifu-cho, Hirosaki, 036 Japan
K. Hozawa, M.D.,
Department of Otolaryngology, Tohoku University School of Medicine, Seiryo-
cho, Sendai, 980 Japan
M. Ikeda, M.D.,
Section of Otolaryngology, Soka City Hospital, Soka, 340 Japan
K. Ikeno, M.D.,
Department of Otolaryngology, Hirosaki University School of Medicine, Zaifu
cho, Hirosaki, 036 Japan
T. Inamori, M.D.,
Assistant Professor, Department of Otolaryngology, Hyogo College of Medicine,
Mukogawa-cho, Nishinomiya, 663 Japan
T. Ishii, M.D.,
Professor, Department of Otolaryngology, Tokyo Women's Medical College,
Kawada-cho, Shinjuku-ku, Tokyo, 162 Japan
Z. Ito, M.D.,
Department of Otolaryngology, University of Tsukuba Institute of Clinical Medi-
cine, Tennodai, Tsukuba, 305 Japan
H. Iwasaki, M.D.,
2-41-105 Saidaijiminami-cho, Nara, 631 Japan
T. Kamimura, M.D.,
Department of Medicine, Hirosaki University School of Medicine, Zaifu-cho,
Hirosaki, 036 Japan
T. Kawase, M.D.,
Department of Otolaryngology, Tohoku University School of Medicine, Seifyo
cho, Sendai, 980 Japan
S. Kishimoto, M.D.,
Associate Professor, Department of Otolaryngology, Kochi Medical School, Nan
goku, 781-51 Japan
M. Kitahara, M.D.,
Professor, Department of Otolaryngology, Shiga University of Medical Science,
Seta, Otsu, 520-21 Japan
H. Kitano, M.D.,
Department of Otolaryngology, Shiga University of Medical Science, Seta, Otsu,
520-21 Japan