Endolymphatic Duct and Sac in Meniere's Disease

PERSUASIVE evidence has come to light in the past several years that structural abnormalities of the endolymphatic duct and sac impairing their resorptive function are a major factor in the pathogenesis of Meniere's disease. The evidence will be presented in two articles, the first on gross observations of the sac at operation with microscopic examination of biopsies of the sac wall; the second will compare polytomographic studies of the vestibular aqueduct in normals and in Meniere's disease with postmortem examination of one of these patients. A third and final article will discuss the practical therapeutic implications that stem from the concept that "idiopathic" hydrops of endolymph, the disease so clearly described by Prosper Meniere in 1861, is most often the result of deficient resorption by the endolymphatic duct and sac. Historical Survey Three years ago, the George M. Coates Memorial Lecture¹concerned a segment of the inner ear almost