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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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