Introduction
Menière’s disease is a chronic, progressive disorder of the inner ear characterized by recurrent vertigo, aural fullness, sensorineural hearing loss, and tinnitus. Endolymphatic hydrops is regarded as a key pathophysiological feature. Although recent studies suggest a possible association between traumatic brain injury (TBI) and Ménière’s disease, this relationship remains unclear due to insufficient clinical data. This study seeks to explore whether blunt TBI may contribute to the development of endolymphatic hydrops and, consequently, to post-traumatic Ménière’s disease. The analysis is based on retrospective survey data, complemented by an extensive literature review and a comparison of the survey findings with current literature.
Materials and Methods
In a retrospective descriptive analysis, 38 members of Swiss Ménière’s disease self-help groups were surveyed using a standardized questionnaire regarding previous blunt TBI, symptom progression, diagnostic work-up, and comorbidities. Thirty-four individuals, 22 women and 12 men, with a confirmed diagnosis of Ménière’s disease according to the Bárány classification were included.
The survey first examined whether previous blunt TBI may contribute to the development of endolymphatic hydrops and, consequently, Ménière’s disease. Based on this assumption, we further hypothesized that mechanical energy transferred to the inner ear during blunt TBI may trigger a pathophysiological cascade leading to endolymphatic hydrops and ultimately to the typical symptoms of Ménière’s disease. To assess this proposed mechanism, a systematic literature comparison was conducted, focusing on pathophysiological mechanisms and empirical evidence linking blunt TBI to the development of endolymphatic hydrops.
Results
A history of previous blunt TBI was present in 16 of the 34 respondents (47.1%), mostly before the age of 20 years. The mean latency until the first occurrence of Ménière’s disease–typical symptoms was 12 ± 8 years. Acute symptoms following the trauma included headache, vertigo, transient loss of consciousness, and hearing disturbances. In the long term, affected individuals reported persistent vertigo, tinnitus, and progressive hearing loss. Endolymphatic hydrops was detected in 14 of 18 examined cases (77.8%).
The literature review showed that high-energy trauma can cause temporal bone fractures, ruptures of the inner-ear window membranes, and damage to the membranous labyrinth. These injuries disrupt endolymph homeostasis and may promote the development of endolymphatic hydrops, which leads to the typical symptoms of Ménière’s disease.
Conclusion
Post-traumatic inner-ear damage represents a possible trigger for the development of endolymphatic hydrops. Both direct mechanical effects and secondary biochemical processes may be involved. Blunt TBI may therefore be regarded as a potential trigger of endolymphatic hydrops, which represents the central feature of Ménière’s disease.