メニエール病の進行と改善における内リンパ水腫の変化

抄録

　To clarify the dynamic changes in the membranous lesions of Meniere's disease, the effects of aerobic exercise on different symptoms were analyzed. Out of a total of 351 patients with Meniere's disease who performed aerobic exercises for 6 months or longer who were enrolled, 338 showed improvement of one or more symptoms: disappearance of vertigo in 97.6% of cases; complete resolution of ear fullness in 60.1% of cases; improvement of hearing impairment in 38.5% of cases; complete resolution or marked decrease of tinnitus in 29.6% of cases. On the other hand, complete recovery of hearing was noted in 29.5% of the 78 patients with low-tone loss, 12.5% of the 96 patients with high-tone loss, and only 4.1% of the 170 patients with hearing loss across all frequencies. More than half of the patients with high-tone hearing loss and hearing loss across all frequencies failed to show any change in the degree of hearing loss. Considering the findings of temporal bone pathology, it seems probable that the Reissner's membrane, being ballooned and highly distended by endolymphatic hydrops, disturbs conduction of low-frequency waves by the perilymph, and the membrane, once it loses tension, is not resonant with either high-frequency waves or indeed waves of any frequency. Although aerobic exercise is effective to cure hydrops and improve membranous tension by activating homeostasis, its effect worsens with decreasing membranous tension.