REFERENSI

1. Runtuwene T, Penyakit Meniere. Dalam Joesoef AA, Kusumastuti K editor. Neuro-otologi Klinis Vertigo. Kelompok Studi Vertigo, Perhimpunan Dokter Spesialis Saraf Indonesia Pengurus Pusat PERDOSSI. Airlangga University Press. Surabaya 2002 : 17 : 142-5 2. Saeed SR. Fortnightly Review : Diagnosis and Treatment of Menieres Disease. BMJ 1998 ; 316 : 368-72 3. Hain TC, Meniere's Disease. Available at http://www.dizziness-and balance.com / disorders / menieres /menieres.html Page last modified : September 4, 2010 4. Brandt T, Dieterich M, Strupp M. Vertigo and Dizziness : common complaints. Springer-Verlag London Limited 2005 : 2 : 64-6 5. Pirodda A, Brandolini C, Raimondi MC, Ferri GG, Modugno GC, Borghi C. Meniere's disease: update of etiopathogenetic theories and proposal of a possible model of explanation. Acta Clin Belg. 2010 May-Jun;65(3):170-5 6. Chandra B. Tatalaksana Vertigo. Dalam Hadinoto S, Wirawan RB, Soetedjo editor. Vertigo diagnosis dan tatalaksana. Badan Penerbit Universitas Diponegoro. Semarang. 1994 : 43-64 7. Hazell J. Information on Mnire's syndrome. Available at http://www.tinnitus.org /home /frame /meniere.htm 8. http://www.menieres-guidebook.com/2009

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Meniere's Disease (MD) is an affection consisting of an association of sensorineural hearing loss, tinnitus and vertigo initially presenting by crises. A review of the most considered possible causative factors and pathophysiologic interpretations allows us to underline the uncertainties which still exist about the genesis of this illness. We propose a mechanistic model based on the effect of a haemodynamic imbalance leading to transient ischaemia which could have an effect on the pH of the inner ear as well as on the work of the inner ear proton pumps. It is hypothesized that under ischaemic conditions and consequent metabolic acidity a preserved proton pump activity can generate an overload of anions in the endolymphatic partition, which is a closed system, thus resulting in an enhancement of osmolarity and consequently in the

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formation of a hydrops resulting in the development of fluctuating hearing loss, tinnitus and vertigo which characterize Meniere's Disease.

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