Saccule Degeneration and Ductus Reuniens Obstruction

Temporal bone changes in a 25-year-old white woman with unilateral saccule degeneration and displacement and encapsulation of the otolithic membrane are described. Fibrous nodules containing clumped statoconia were present, obliterating the cochlear portion of the ductus reuniens, with marked distension of the cochlear cecum vestibulare. The patient had had acute labyrinthitis four years prior to death, with continuing episodes of vertigo and tinnitus. Two years before death, a primary malignant melanoma of the skin had been removed. Both temporal bones, at death, contained metastatic melanoma within the internal auditory canals. The possibility of the changes representing focal complications of a previous viral labyrinthitis, or complications due to venous obstruction from tumor metastases, is discussed.