ENDOLYMPHATIC HYDROPS IN CHILDREN

Apart from clinical observations of Meniere's disease in children, the re have only been a few histological descriptions of endolymphatic hyd rops (EH) as an incidental finding in children. In this paper we repor t on the incidence of EH in temporal bones of children. One hundred ei ghteen temporal bones from 70 infants between newborn and 10 years (av erage age 12.9 months) were analyzed by light microscopy for EH of the cochlear duct, which was defined as a bulging of Reissner's membrane into the scala vestibuli in more than one turn of the cochlea. All end olymph spaces were carefully examined for factors such as an obliterat ed ductus reuniens which may have contributed to the development of EH . In 64 (54.2%) of the 118 temporal bones, a bulging of Reissner's mem brane in the cochlear duct was found. In 65.6%, the bulging was confin ed to the apical turn and since the significance of isolated apical hy drops is controversial, we elected not to consider this group as havin g hydrops. Twenty (16.9%) bones met our criteria for a diagnosis of EH . Compared to the high incidence of bulging in the cochlear duct, fewe r saccules and utricles were dilated. In approximately half of the tem poral bones (49.2%), the ductus reuniens was collapsed. The ductus reu niens seems to be closed in its normal position and might open when pr essure occurs due to an increasing volume of endolymph. If there is a permanent closure, EH may result. Our investigation does not indicate that EH is associated with a specific disease; however, where there we re congenital anomalies the incidence of EH was higher. The endolymph system seems to be sensitive to external disturbances, and EH is possi bly related to many kinds of metabolic disorders of early infancy.