Possible functional roles of Na+,K+-ATPase in the inner ear and their relevance to Ménière's disease.

This article reviews the functions of the enzyme Na+,K+-ATPase in epithelial tissues and discusses early and recent biochemical, physiologic and morphologic studies of the enzyme in the inner ear. The purpose of the investigation was to learn whether a relationship between perturbations in activity of the enzyme and Ménière's disease is possible. It is concluded that the preponderance of the evidence indicates that Na+,K+-ATPase plays a role in regulating ion transport into the scala media, but that the significance of the distribution of the enzyme along only one cell type (the marginal) in the functional chains of cells of the outer cochlear wall needs further study. The possible vasoconstrictive effects of ouabain perfusions employed by some investigators must also be taken into account. Recent cytochemical and autoradiographic studies have demonstrated high levels of Na+, K+-ATPase on cochlear nerve fibers, especially near the foramina nervosa and within the organ of Corti. Thus, perturbations in Na+,K+-ATPase activity in the inner ear not only could affect certain aspects of fluid balance, but also could account for the sensory disturbances experienced by patients who have Ménière's disease.