Endolymphatic hydrops is the pathophysiological hallmark of Menière's disease. The current leading theory for its mechanism involves:

• A Autoimmune destruction of the stria vascularis leading to excess endolymph production
• B Impaired endolymph reabsorption via the endolymphatic sac, causing endolymphatic pressure build-up and eventual membrane rupture ✓
• C Caloric hypersensitivity of the horizontal semicircular canal
• D Perilymphatic fistula causing endolymph leakage into the perilymphatic space

Explanation

Endolymphatic hydrops in Menière's disease is primarily attributed to dysfunction of the endolymphatic sac (ELS) in reabsorbing endolymph. Genetic factors (COCH gene variants), immune dysregulation, and vestibular aqueduct obstruction impair ELS transport function, causing endolymph accumulation. Progressive distension culminates in rupture of Reissner's membrane, mixing endolymph (high K+) with perilymph — triggering the acute vertiginous episode. Healing of the membrane ends the attack.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.