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Although endolymphatic hydrops is generally considered to be the most prominent factor in the etiology and pathology of Ménière's disease, we have concluded that this condition more probably represents a polyganglionitis caused by the herpes simplex virus with secondary hydrops changes. The wide range of symptoms occurring in the Ménière's disease complex is illustrated in seven selected cases which support this conclusion. Vestibular nerve section can stabilize hearing and relieve episodic vertigo by removing the locus of viral infection and precluding recurrent activation.

We conducled a study of 80 patients 10 evaluate the accuracy ofa commercially avai lable acoustic reflectometer in identifying the presence OI' absen ce ofotitis media with effusion (OME). This device assesses bilatera l tympanic mem bran e mobili ty and, by inference, middle eal' status. Wefound that il was most accurate in patients with nonnai andgrosslyjluid-filledears. We reconunend screening with this acouslic reflectometer 10 nt/e out OME in adu lt and p edialric patients.

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