Endolymphatic hydrops after total dissection or cauterization of the distal portion of the endolymphatic sac

In this study, a more subtle animal model of Menière's disease is investigated by damaging the distal portion of the endolymphatic sac by dissection or cauterization to produce mild dysfunction of endolymphatic outflow. Cauterization resulted in low degrees of hydrops without any correlation with the inflicted damage. Total dissection of the distal portion of the sac adjacent to the sigmoid sinus produced moderate to severe endolymphatic hydrops with interanimal variation. The consequences of these relatively severe effects, in relation to the mild damage of the endolymphatic sac, and the influence on damaged and undamaged parts of the endolymphatic sac will be discussed.

Lermoyez's syndrome. A follow-up study in 12 patients

Clinical studies were performed in 12 patients with the Lermoyez syndrome during a close follow-up of 2 to 31 years. The nature and temporal sequences of the symptoms of these patients are described. The incidence of Lermoyez's syndrome, as compared with Meniere's disease, is almost 18%. This is much higher than usually is assumed. In 6 out of 12 patients typical Meniere attacks were found besides their Lermoyez attacks. Almost every one of the 12 patients showed, besides the Lermoyez attacks, also hearing fluctuations without vertigo, and vertigo without hearing fluctuations. The type of vertigo was usually rotating, often with unsteadiness and in 3 patients dropping attacks were sometimes observed. The typical Lermoyez attack lasted several hours. The preceding hearing loss lasted for days to months. The hearing recovered after the attacks and remained stable for days to months. An improved hearing was noticed within some hours after the vertiginous attack in 9 out of 12 cases. Three patients noticed the hearing improvement already during the attack. In 8 out of 12 cases the disease became bilateral.

Early hair cell loss in experimental hydrops

One, 2, and 4 months after surgical obliteration of the endolymphatic sac, the sequence of degenerative changes in the organ of Corti of the guinea pig was studied. The block surface technique with interference differential (Nomarski) microscopy was used for this investigation to study the morphological changes in the organ of Corti. The hair cell loss was calculated and mapped in cytocochleograms. One month postoperatively a minimal loss of only outer hair cells was observed in the apical cochlear turn. At 2 months a progression of outer hair cell loss was seen, which proceeded in the 4-month group. At 4 months the inner hair cells showed a slight tendency to degenerate, again beginning in the most apical part of the cochlea.

Unrelated sensorineural hearing loss in patients with otosclerosis. A report of three cases

Although it is generally accepted that 20% or more of patients with clinically manifest otosclerosis have a concomitant sensorineural hearing loss, it is still debated whether otosclerosis is the cause of the neural loss. Three cases are presented of other causes of sensorineural loss in otosclerotic patients who underwent stapes surgery. One of these cases, the Mondini malformation, is discussed in detail.

A multidimensional study of personality traits ad modum Sjöbring

Three groups of epileptic out-patients (juvenile myoclonic epilepsy, psychomotor epilepsy, and cryptogenic grand mal) were studied. The groups were matched as closely as possible with each other with regard to sex, age, and treatment. Out-patients suffering from Menière's disease served as a control group; these patients were treated with placebo and matched with the epilepsy groups with regard to sex, duration of disease and social level. The Marke-Nyman inventory was used as a quantitative assessment of personality traits. This inventory is an operative definition of Sjöbring's neurophysiological model of personality, including the three dimensions: validity, stability and solidity. Our results showed that epileptic patients irrespective of the type of seizures were substable. Low validity was found in patients with juvenile myoclonic epilepsy and in patients with psychomotor epilepsy with temporal EEG focus. In those latter epilepsy groups a tendency to subsolidity was also observed. In Sjöbring's frame of reference these substable patients of low validity have a psychological vulnerability since they are unable to overcome the small concrete adversities of life. They adhere to problems, and being unable to solve them they tend to react in a mood of discontent or of maladjustment. In the usual psychiatric frame of reference substable patients of low validity are classified as psychoastenic patients with emotional instability.

Personality tests in Ménière's disorder

The personality of patients with Ménière's disorder has been evaluated using the Eysenck Personality Inventory and the Middlesex Hospital Questionnaire. The most notable finding was an elevated obsessionality score in the patients with Ménière's disorder as compared with other groups. There was no significant difference between the personality of subgroups of patients complying with rigid definitions of Ménière's disorder and those complying with a more liberal definition. The results of most scales decreased with increasing severity of the disorder, although the obsessionality scores do not follow this tendency.