A Pathoanatomical Study of the Endolymphatic Sac in Ménière’s Disease

It has been well established by anatomic and tomographic reports [1, 2] that the endolymphatic sac (ELS) and vestibular aqueduct (VA), appear in great varieties of size, position, course, and form. These irregularities are particularly pronounced in Meniere’s disease, with tomographic studies revealing the VA to be filiform, stenotic, or nonvisualized in more than 50% of all Meniere’s cases [3, 4]. Such tomographic findings were used by Stahle and Wilbrand [4, 5] in the development of a system classifying the degree of peri-aqueductal pneumatization in Meniere’s disease into 3 grades: large cell pneumatization, small pneumatization, and non-pneumatization.