Abstract
The reality of allergic endolymphatic hydrops as a cause of recurrent episodes of Meniere's disease was suggested from the results of the following studies: 1) Clinical studies
a) The skin test using 34 sorts of food antigen extracts and the glycerol test were performed on 23 patients with Meniere's disease. The rate of positive glycerol test was higher in the group with the positive skin reaction than in the negative group (p=0.05).
b) In some patients, whose episodes were provoked by the challenge-feeding test, improvement in hearing was produced after Portmann's endolymphatic operation. 2) Experimental studies
a) Labyrinthine reactions were produced when challenged with the antigen through the left foramen stylomastoideum in 4 groups of rabbits as follows: (A) rabbits sensitized by hen's serum, (B) control rabbits, (C) rabbits inoculated with BCG vaccine and (D) control rabbits. Among these 4 groups, the positional nystagmus observed in group A bore a striking resemblance to that of Meniere's attack. The electrocochleograph of group A showed a pattern of cochlear impairment and a histological study revealed endolymphatic hydrops in the ear on the challenged side. This endolymphatic hydrops was not found in the other groups. From these findings, endolymphatic hydrops does not appear to be induced by cell-mediated immunity, but by humoral immunity.
b) To determine the place of antigen-antibody reaction, the labyrinths of guinea pigs sensitized by horseradish peroxidase (HRP) were investigated by electronmicroscopy after challenge with this antigen through the perilymphatic space. Particles of HRP could pass through the Reissner's membrane by intracellular transportation and clung to the surface of dark cells in the stria vascularis. These findings were not observed in the control study and suggest that hyper-permeability of the Reissner's membrane and hypersecretion of the stria vascularis induced by the antigen-antibody reaction are probable causes of endolymphatic hydrops.
