Menière's disease; pathogenesis of vestibular dysfunction and new diagnostic tests

PhD ceremony: Ms. C.M. Kingma, 14.45 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Menière's disease; pathogenesis of vestibular dysfunction and new diagnostic tests

Promotor(s): prof. H.P. Wit, prof. B.F.A.M. van der Laan

Faculty: Medical Sciences

Menière’s disease (MD) is characterised by three symptoms: fluctuating hearing loss, episodic vertigo, and tinnitus. Although vertigo is the most severe complaint in MD, it has not been studied widely. The focus of this research was on the function of the vestibular system as an explanation for vertigo in MD.

An animal model was used to investigate the function of the vestibular system. The creation of an acute endolymphatic hydrops in the vestibular system did not cause the symptoms of MD. In case the hydrops resulted in a rupture of Reissner’s membrane, it caused an immediate and complete suppression of the function of the vestibular system. The influence of potassium ions leaking through the ruptured membrane on the sensory and neural structures in the vestibular system is the most likely explanation for the development of vertigo. It is concluded that the ‘membrane rupture hypothesis’ of MD is confirmed by the animal model for rupture and recovery of Reissner’s membrane that mimicked an episode of MD.