R444 – Deposits in Semicircular Canal in Meniere's Disease

Abstract

Problem Positional vertigo is a common complaint in patients with Meniere's disease. Benign paroxysmal positional vertigo has been postulated to be the result of free-floating degenerative otoconia in the semicircular canal (canalithiasis) or debris that becomes adherent to the cupula (cupulolithiasis). A recent retrospective review of a large population of patients with benign paroxysmal positional veritigo reported a high rate of association of benign paroxysmal positional veritigo and Meniere's disease. The purpose of this study was to investigate the incidence of deposits in the semicircular canals of patients with Meniere's disease compared to their incidence in normal bones. Methods Temporal bones included: 22 from 11 patients with bilateral Meniere's disease; 38 temporal bones from 19 patients with unilateral Meniere's disease, and 50 age-matched normal controls from 30 individuals. Results There was a significant difference between normal and diseased temporal bones in the incidence of cupular deposits (p = 0.007 in bilateral and p = 0.01 in Unilateral) and free-floating deposits (p = 0.007 in bilateral; p = 0.002 in Unilateral) in the posterior semicircular canal. There was no significant difference between normal and diseased temporal bones in the incidence of deposits in other canals. Conclusion The higher prevalence of free-floating degenerative otoconia and cupular deposits in the posterior semicircular canal in Meniere's disease indicates their possible association to benign paroxysmal positional vertigo. Further clinical and pathological studies are required to confirm this association. Significance Canalithiasis or cupulolithiasis may be possible causes of benign paroxysmal positional vertigo in patients with Meniere's disease. Support International Hearing Foundation, Hubbard Foundation, Starkey Foundation.