Temporal bone findings in a 75-year-old man with a 34-year history of unilateral Meniere syndrome showed severe subepithelial fibrosis of the intermediate endolymphatic sac, bilaterally. The nonhydropic side showed narrow patency of the utriculoendolymphatic valve together with questionable "fullness" of the saccule duct and slight bulging of the adjacent free wall of the saccule.
The vein of the vestibular aqueduct, on the same side, drained spontaneously into a large vascular channel within bone marrow, in its course toward the posterior fossa, before joining with the tissue of the vestibular aqueduct. This was not present on the hydropic, Meniere side. The collateral drainage of the vein of the vestibular aqueduct may have acted as a spontaneous shunt, compensating the fluid mechanics to an extent where incipient hydrops, only, was present.