The relationship between perilymph and cerebrospinal fluids in Ménière’s disease: New findings in RMI after intratympanic administration of gadolinium Meniere’s Disease

The attention of the researches on the pathogenesis of MD was frequently focused on EN pressure fluctuation or its electrolytic variations and the PE was considered a fluid ‘adaptable’ to endolymphatic changes. The escape of GD in the IAC highlights a different pathophysiology, showing how in the MD the IAC is the main place of the perilymphatic dispersion, and confirms the existence of a continuous stream of GD from the round window to the IAC. In our opinion, the changes in pressure of the CSF by changing the perilymphatic pressure, and then the endolymphatic pressure through the Reissner membrane, could play a role in causing or maintaining idiopathic MD.