Allergy of the inner ear.

Abstract

ALLERGY, whether it is of the immunologic or physical type, appears to be basically a localized autonomic dysfunction of the cholinergic type. This dysfunction produces a stereotyped reaction of the peripheral vascular bed (the arteriole, capillary, and venule) in which arteriolar spasm is associated with dilatation of the capillary and venule that sometimes amounts to a varicosity. Muller termed this condition the spastic-atonic state. Anoxia of the capillary loop, with injury to the endothelium and contained circulating cells, follows. Such anoxia results in sludging of the blood, local release of toxic metabolites, and increased permeability of the capillary loop. The last, in turn, results in the formation of the typical allergic wheal. When allergy affects the inner ear, this invariable reaction of the capillary bed may involve either the stria vascularis or branches of the internal auditory artery supplying the cristae and maculae, or the two together. Involvement of the