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Laryngorhinootologie 2005; 84(6): 412-417
DOI: 10.1055/s-2005-861120
Otologie
© Georg Thieme Verlag KG Stuttgart · New York

Neue Konzepte zu einer Pathophysiologie des M. Menière auf zellulärer Ebene

Towards a Cellular Pathophysiology of Menière's DiseaseP.  Düwel1 , L.-E.  Walther1 , T.  Haasler1 , M.  Westhofen1 , A.  Lückhoff2
  • 1 Klinik für HNO, Universitätsklinikum der RWTH Aachen
  • 2 Institut für Physiologie, RWTH Aachen
Further Information

Publication History

Eingegangen: 10. August 2004

Angenommen: 20. Dezember 2004

Publication Date:
12 April 2005 (online)

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Zusammenfassung

Hintergrund: Eine geringfügige Erhöhung des hydrostatischen Drucks im endolymphatischen Raum kann zu einem endolymphatischen Hydrops führen, der wiederum in charakteristischer Weise mit einem M. Menière einhergeht. Indessen gibt es bislang kein überzeugendes pathophysiologisches Modell, das auf zellulärer Ebene erklärt, wie eine solche Druckerhöhung für eine gestörte Funktion der vestibulären Haarzellen und einen Menière-Anfall ursächlich sein könnte. Methode: Bisherige Modelle führen entweder osmotische Ursachen mit der Folge von Elektrolytverschiebungen im Endolymphraum an, oder es wird ein gestörter longitudinaler Fluss im Endolymphraum verantwortlich gemacht. Ergebnisse: Unlängst wurde nun ein drucksensitiver Kaliumstrom in vestibulären Haarzellen identifiziert und charakterisiert. Schlussfolgerung: Dieser Strom kann das Frequenzverhalten der Zelle modifizieren und kann möglicherweise als das „missing link” einer zellulären Pathophysiologie des Hydrops verstanden werden. Pharmakologische Beeinflussung von Ionenströmen in der Haarzelle stellt für die Zukunft einen attraktiven Ansatz für therapeutische Interventionen beim M. Menière dar.

Abstract

Background: A modest increase in the hydrostatic pressure within the endolymphatic space may induce an endolymphatic hydrops which in turn is typically associated with Menière's disease. However, there is no convincing pathophysiological model that might explain, on a cellular level, how a pressure increases may cause disturbed functions of vestibular hair cells and vertigo attacks. Methods: So far, models involve osmotic mechanisms leading to electrolyte imbalances in the endolymphatic space. Alternatively, impaired longitudinal flow in the endolymphatic space is considered important. Results: Recently, a pressure-sensitive potassium current was identified and characterized in vestibular hair cells. Conclusions: This current may modify the frequency behavior of a cell and may be the „missing link” in a cellular pathophysiology of the hydrops. Ion currents in hair cells offer attractive targets for pharmacological interventions in Menière's disease.

Schlüsselwörter

Menière - Schwindel - Haarzelle - Physiologie - Ätiologie - Kalzium - Kalium - Ionenströme - endolymphatischer Hydrops - Therapie - vestibulär

Key words

Menière’s disease - vestibular - hair cell - vertigo - dizziness - physiology - potassium - calcium - Hydrops - therapy

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Dr. med. Philip Düwel

Klinik für Hals-, Nasen- und Ohrenheilkunde und Plastische Kopf- und Halschirurgie, Universitätsklinikum Aachen

Pauwelsstraße 30 · 52057 Aachen

Email: pduewel@ukaachen.de

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