In order to examine the immunocytologic features of the proposed association between HLA-B27 and Meniere disease, we devised a protocol involving the fluorescence-labeled reaction of human serum with mouse inner ear sections.
These results suggest that a humoral immune response--specifically an antigen-antibody reaction--may underlie the development of Meniere disease symptomatology in carriers of HLA-B27.
We have described the cases of 2 patients with signs and symptoms of autoimmune Meniere disease who were found to be HLA-B27 carriers.
Yet a group from Spain reported no association between Meniere disease and HLA-A, -B, -C, or -DR alleles.
17) Our investigation of 2 patients with HLA-B27--associated Meniere disease also found evidence of the presence of autoantibodies against inner ear structures in the serum of both of patients.
A link between HLA-B27 and autoimmune Meniere disease will require a much larger sample.
All patients in this study had unilateral Meniere disease, as described by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery, (5) and intractable vertigo.
Also, the natural fluctuations in hearing that accompany Meniere disease must be considered.
A small percentage of patients in each group had hearing loss after treatment, but the significance of this result is difficult to assess because of the natural fluctuations in hearing with Meniere disease.
A few years ago, we were performing an average of 12 vestibular neurectomies per year, but during the 5 years since we started using intratympanic gentamicin for intractable vertigo of Meniere disease, we have performed only 2.
Results of this study support the efficacy of intratympanic gentamicin injections for eliminating intractable vertigo episodes in Meniere disease.
Results at 3 months after intratympanic gentamicin injections to treat Meniere disease Group 1: Group 2: Subjective end Objective end points (n = 81) points (n =23) Patient demographics Female:male 49:32 13:10 Age range (median) 30-80 yr (53 yr) 24-71 yr (48 yr) Average time from 8 yr 4.