The Critical Role of Reissner’s Basement Membrane in Meniere’s Disease

Abstract

Endolymphatic hydrops refers to pathologic
distention of the membranous labyrinth [1].
Such hydropic distention constitutes the
histologic correlate of the clinical entity
known as Meniere’s Disease [2]. When these
distended membranes rupture they are thought
to release potassium ions into the surrounding
perilymph. Such potassium ions are suspected
to result in a neuronal depolarization that
induces the clinical symptom of vertigo in
Meniere’s disease patients [3]. It should
be noted that some authorities question
this causal relationship [4]. However, the
efficacy of labyrinthectomy in permanently
eliminating the vertigo attacks argues strongly
for the labyrinth to be the source of the clinical
symptoms [5] while leaving open the question
of the exact pathophysiological mechanism.
This hydropic membrane distention is not
uniform across the labyrinth but preferentially
affects the Reissner’s membrane of the cochlea
duct and the saccular membrane [6]. Optical
microscopy reveals that Reissner’s membrane
and the saccular membrane of the pars inferior
labyrinth are much thinner than those of the
pars superior chambers.