Abstract

OBJECTIVE/HYPOTHESIS: This study was designed to investigate the hypothesis that Menieretextquoterights disease is associated with herpes simplex virus (HSV) reactivation in the vestibular ganglion.

STUDY DESIGN: Case control study.

METHODS: Vestibular ganglia were obtained from archival surgical pathology specimens from patients undergoing vestibular neurectomy for vertigo caused by Menieretextquoterights disease. All patients met criteria for classification as definite Menieretextquoterights disease according to American Academy of Otolaryngology/Head and Neck Surgery (AAO-HNS) criteria. Control specimens were obtained from willed body donors. Sections from each ganglion were studied for prevalence of viral DNA using a nested polymerase chain reaction designed to amplify the HSV DNA polymerase gene. Quantitative analysis determined the number of viral copies per standard unit of ganglionic DNA.

RESULTS: HSV DNA was more prevalent in paraffin embedded ganglia from patients with Menieretextquoterights disease (100%) than in fresh-frozen control ganglia (81%) (P =.02). Fixation and paraffin embedding substantially reduced recovery of HSV virus in selected control specimens. Quantitative analysis found no correlation between viral copy number in control ganglia processed frozen versus formalin fixed and paraffin embedded.

CONCLUSIONS: HSV is more commonly isolated from vestibular ganglia of patients with Menieretextquoterights disease than the general population. The routine histologic preparation of formalin fixation and paraffin embedding significantly altered the quantity of virus detected though not in a predictable manner. The study provides supportive evidence for a viral etiology in Menieretextquoterights disease.