A proposed mechanism by Lustig et al states that low cerebrospinal fluid (CSF) pressure can be transmitted to the cochlea through the
cochlear aqueduct. (4) Low CSF pressure may induce low perilymphatic pressure and, in theory, low perilymphatic pressure may trigger a pressure imbalance, leading to compensatory endolymphatic compartment swelling.
(1-7) It is presumed that the relationship involves the transmission of CSF pressure to and from the perilymphatic space through a patent
cochlear aqueduct (figure 1).
Patient 3's
cochlear aqueduct was normal; her vestibular aqueduct on the operative side was not visible.
(2) In bacterial meningitis, the infection spreads to the inner ear via the subarachnoid spaces (e.g., the
cochlear aqueduct and the internal auditory canal).
In such cases, it is possible that a patent or semipatent
cochlear aqueduct or modiolus would allow for hydrodynamic changes in pressure to occur concurrently with volume changes between the perilymph and spinal fluid in the adjacent subarachnoid space, but this is difficult to confirm.
The infection spreads to the inner ear via subarachnoid spaces, such as the
cochlear aqueduct and the internal auditory canal.