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美尼尔氏病的病因仍未明确,通常认为有多种发病因素参与。截至1980年报道的70例尸解病例,近乎95％表现为内淋巴积水,约1/3病例有内淋巴囊纤维化,极少数报道在扩张的前庭膜和球囊见到破裂痕迹。内淋巴积水也见于梅毒、中耳炎或病毒感染的炎症过程、手术或外伤引起的迷路瘘孔、某些先天性疾患、Cogan综合征等。据此Schuknecht分内淋巴积水为①先天性;②后天性(外伤或炎症);③特发性。美尼尔氏病属特发性。因此有内淋巴积水者未必表现出与美尼尔氏病相同的症状。证明内淋巴积水的方法有:口服甘油以改善纯音听阈;静脉注射速尿以改善冷热试验性眼震或摆动旋转眼震;耳蜗电图检查出现优势-SP,服速尿而使其减小等。
The etiology of Meniere’s disease remains unclear, and it is often thought that a variety of factors are involved. Approximately 95% of the 70 autopsy cases reported as of 1980 were lymphatic hydrops and about 1/3 of the cases had endolymphatic fibrosis, with very few reports of rupture of the anterior wall of the expanding vestibular membrane and balloon. Endolymphatic hydrops are also seen in syphilis, the inflammatory processes of otitis media or viral infections, labyrinthine fistula holes caused by surgery or trauma, certain congenital disorders, Cogan’s syndrome, and the like. According to Schuknecht sub-lymphatic hydrops ① congenital; ② acquired (trauma or inflammation); ③ idiopathic. Meniere’s disease is idiopathic. Therefore, patients with endolymphatic hydrops do not necessarily exhibit the same symptoms as Meniere’s disease. Methods to prove the endolymphatic hydrops are: oral glycerol to improve pure tone audiometry; intravenous furosemide to improve cold and heat test nystagmus or swing rotation nystagmus; cochlear electrocardiogram check advantage-SP, Small and so on.