Mediterr. J. Otol 2007; 3:(1)

Perisaccular Vascular Obstruction During an Acute Attack of Meniere’s Disease

Maurizio Barbara, Simonetta Monini, Ilaria Chiappini, Francesco Ronchetti, Salvatore Raffa, Maria Rosaria Torrisi

Departments of Neurology and Otorhinolaryngology and Experimental Medicine, University La Sapienza, II Medical School, Rome, Italy  maurizio.barbara@uniroma1.it

This ultrastructural study of the endolymphatic sac (ES) was performed on a sample taken during ES ablation surgery from a patient who was experiencing an acute attack of Meniere’s disease. The sample consisted of the most proximal extraosseous portion of the ES, including both walls. No evidence of epithelial damage was observed, and the sample showed signs of high metabolic activity in all cellular components. The most striking findings were found at the level of the subepithelial space, where diffuse signs of vascular thrombosis were identified. The intravascular occlusion was variously represented by sludged erythrocytes and an amorphous, lipid-like material. The occlusion of perisaccular vessels seems to be a pathognomonic finding of active Meniere’s disease