{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T23:13:56Z","timestamp":1769382836986,"version":"3.49.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T00:00:00Z","timestamp":1535414400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215118001366_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The cause of M\u00e9ni\u00e8re's disease remains enigmatic after 156 years. Schuknecht's rupture and potassium intoxication theory of attacks was based on histological studies.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118001366_sec_a2\"><jats:title>Objectives<\/jats:title><jats:p>This paper aimed to: present the most contemporary evidence indicating that ruptures do not usually occur, and discuss the possibility that detached saccular otoconia are the main cause of M\u00e9ni\u00e8re's disease; and to establish an unequivocal definition of the age of M\u00e9ni\u00e8re's disease onset.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118001366_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>The paper reviews the electrophysiological basis of the Gibson\u2013Arenberg drainage theory used to explain vertigo attacks. The current, limited knowledge of the likely fate of detached saccular otoconia is discussed.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118001366_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Electrophysiological studies during attacks do not support endolymph ruptures, but rather endolymph flowing in one direction and then in the opposite direction. Age of onset for M\u00e9ni\u00e8re's disease parallels that for benign paroxysmal positional vertigo.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118001366_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>The similarity of age of onset spectrum for M\u00e9ni\u00e8re's disease and benign paroxysmal positional vertigo raises the possibility that the two conditions have the same fundamental cause.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215118001366","type":"journal-article","created":{"date-parts":[[2018,8,28]],"date-time":"2018-08-28T08:50:41Z","timestamp":1535446241000},"page":"771-774","source":"Crossref","is-referenced-by-count":17,"title":["Saccular otoconia as a cause of M\u00e9ni\u00e8re's disease: hypothesis based on two 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