title: Sensory cell damage in two-phase endolymphatic hydrops: a morphologic evaluation of a new experimental model by low-voltage scanning techniques.
abstract: OBJECTIVE
  The aim of this study was to create a more dynamic animal model of Ménière's disease combining multiple causes, such as the role of endocrine factors and endolymphatic sac dysfunction, that may mimic the fluctuant characteristics of Ménière's disease.
  
  
  BACKGROUND
  Endolymphatic hydrops remains to be considered a pathologic substrate in the etiology of Ménière's disease. The classic guinea pig model of inducing hydrops by total destruction of the endolymphatic sac is a nonphysiologic rigid model of Ménière's disease.
  
  
  METHODS
  The authors developed the two-phase endolymphatic hydrops model by inducing hydrops by mild chronic endolymphatic sac dysfunction, in combination with increased endolymph production by aldosterone. Sensory cell damage was evaluated by low-voltage field emission scanning microscopy.
  
  
  RESULTS
  This study describes a wide spectrum of morphologic effects of the outer hair cells in radial gradients, in which most effects were observed in the third to second row of outer hair cells, and longitudinal gradients in which the most severe effects were observed in the apical turns. Most affected were the ears that underwent distal endolymphatic sac dissection followed by the administration of aldosterone. Damaging effects proceeded from degeneration and absence of short stereocilia of outer hair cells and even some inner hair cells in the apical turns, to stereociliary disarrangement and atrophy, followed by degeneration and absence of outer hair cells, which were replaced by supporting cells.
  
  
  CONCLUSIONS
  The two-phase endolymphatic hydrops model seems to represent a functional model that may mimic the fluctuant characteristics of Ménière's disease and emphasizes the influence of multiple and coexisting hydrops-inducing influences.
authors.affiliation: Department of Otorhinolaryngology, University Hospital Groningen, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: Dunnebier
authors.forename: J M
authors.initials: JM
authors.lastname: Segenhout
authors.forename: F
authors.initials: F
authors.lastname: Dijk
authors.forename: F W
authors.initials: FW
authors.lastname: Albers
mesh_terms: D000818:Animals; D018159:Endolymphatic Hydrops / Q000473:pathology*; D004712:Endolymphatic Sac / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D017950:Ganglia, Sensory / Q000473:pathology*; D006168:Guinea Pigs; D018072:Hair Cells, Auditory, Outer / Q000473:pathology; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology; D008855:Microscopy, Electron, Scanning / Q000379:methods; D009410:Nerve Degeneration; D009925:Organ of Corti / Q000473:pathology