Overview

• Sex: ♀ ≥ ♂

• Onset: 20–60 years of age

• Peak incidence: 40–50 years

• Prevalence: 50–200 in 100,000 individuals in the US

• Idiopathic

• Several etiologies have been proposed, including:

  • Viral infections

  • Autoimmune disease

    • Inner ear autoimmune disease

    • Systemic autoimmune disease

  • Allergies

All patients with Meniere disease have impaired endolymph resorption that results in endolymph hydrops. However, not all patients with endolymphatic hydrops have symptoms of Meniere disease. The cause of impaired resorption is unknown. There are currently two main theories about why some patients develop symptoms:

• Endolymph hydrops: accumulation of fluid in the endolymphatic sac.

• Rupture theory: fluid accumulation in the endolymphatic sac → tear in the Reissner membrane → increased perilymphatic potassium → depolarization of the afferent acoustic nerve fibers → symptom onset

• Compression theory: impaired endolymph resorption → compression of the semicircular canals → symptom onset

The endolymph is rich in potassium and perilymph is rich in sodium. In Meniere disease, the concentration of potassium in the perilymph increases.