Pathogenesis and pathophysiology of Meniere’s disease: An update

Meniere’s disease is known with certain clinical symptoms such as fluctuating hearing loss, episodic vertigo, and tinnitus and characterized by endolymphatic hydrops found on post-mortem examination. The pathophysiology of Meniere’s disease is still questionable, and it has not been fully understood despite almost a century of research. Many determinants are effective in the occurrence of endolymphatic hydrops and in the pathogenesis of relevant cochleovestibular dysfunction. This review discusses research studies conducted in recent years concerning the pathogenesis and pathophysiology of Meniere’s disease. Histopathological research studies conducted in recent years on patients with Meniere’s disease have often focused on certain subjects as follows: aquaporins, oxidative stress, genetics, cochlear lateral wall changes, longitudinal flow blockage, intraskeletal channels of the otic capsule, hydropic and cellular changes in Reissner’s membrane, cochlear hair cells and spiral ganglion cells, round window thickness, basement membrane pathology, and otolithic membrane damages. Recent studies conducted on pathogenesis mechanisms of Meniere’s disease would provide an insight for the improvement of diagnosis and treatment of this weakening disease.