Detection of viral DNA in vestibular ganglia tissue from patients with Meniere's disease

The main goal of this study was to examine the vestibular ganglia from 11 patients with intractable classic Menière's disease (MD) for the presence or absence of DNA from three neurotropic viruses (herpes simplex virus, cytomegalovirus, and varicella zoster virus) using exquisitely sensitive molecular biologic techniques. This was a prospective controlled study with vestibular ganglia from patients with MD and from patients with small vestibular schwannomas undergoing resection. Polymerase chain reaction was used for viral DNA detection from the ganglia along with known positive and negative polymerase chain reaction control subjects. The study was performed in an academic tertiary referral center. Patients for inclusion had medically uncontrolled MD, including documented fluctuating sensorineural hearing loss, episodic vertigo, and tinnitus who elected to undergo vestibular nerve section. Control patients were undergoing vestibular schwannoma removal. The intervention was vestibular nerve section with removal of vestibular ganglion. The presence or absence of viral DNA (herpes simplex virus, cytomegalovirus, and varicella zoster virus) in vestibular ganglion tissues detected by polymerase chain reaction. No viral DNA was detected in the vestibular ganglia of patients with MD (p = 0.028) nor in the control group. The likelihood of a type II or beta type error was < 10%. In patients with MD requiring surgical intervention, infection with herpes simplex virus, cytomegalovirus, or varicella zoster virus of the vestibular ganglia does not appear to play a major role in the pathoetiology of the disease.