It is thought that the gentamicin permeates the perilymph and the endolymph of the inner ear through the round and oval window membranes and damages the vestibular hair cells.
Canalithiasis is the most commonly accepted mechanism, wherein the otoliths that detach from the utricle or saccule and floating freely in the endolymph system of the semicircular canals cause neuronal stimulation.
Substances penetrating from the middle ear into the inner ear through the round window cause biochemical changes in perilymph and endolymph. Only the preserved and fully functional ossicular chain has a favorable impact on inner ear function.
On the contrary, statoliths of squid, sepiids, and sepiolids accrete calcium carbonate from the statocyst endolymph with constant periodicity (Jackson 1994, Arkhipkin 2005).
Enzymatic activities, vascular insult during active phase, toxic substances from otosclerotic focus, and biochemical change in endolymph and perilymp could be some of the reasons (8).
Changes in hearing ability are usually caused by fatigue in nuclei of the central auditory pathways, reduced activity of the primary afferent neurons, decreased oxygen tension in the cochlear endolymph and local vasoconstriction, particularly of the stria vascularis.
BPPV is caused by free otoconia dislodged from the utricular macula that have entered the semicircular canal, where they provoke an inappropriate flow of endolymph whenever the head is rotated in the plane of the affected canal [15].
The criterion for success in the dehiscence model was a thin endosteum in the dehiscence (seen in the schematic diagram of the section plane (Figure 2(a)) and H&E staining; Figure 2(b)), demonstrating clearly the fluid areas of the endolymph and perilymph.
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