Endolymphatic Hydrops

Endolymphatic hydrops is a disorder of the vestibular system of the inner ear. It stems from abnormal fluctuations in the fluid called endolymph, which fills the hearing and balance structures of the inner ear.

In a normal inner ear, the endolymph is maintained at a constant volume and contains specific concentrations of sodium, potassium, chloride, and other electrolytes. This fluid bathes the sensory cells of the inner ear and allows them to function normally.

If the inner ear is damaged by disease or injury, the volume and composition of the inner-ear fluid can fluctuate with changes in the body's fluid and electrolyte levels. This fluctuation causes the symptoms of hydrops -- pressure or fullness in the ears, tinnitus (ringing in the ears), hearing loss, dizziness, and imbalance.

The goal of treatment is to provide stable body fluid levels so that secondary fluctuations in the endolymph can be avoided.

Causes
Endolymphatic hydrops may occur as a result of a head blow, infection, degeneration of the inner ear, allergy, or (rarely) a tumor, or the cause may be unknown.

Managing the Symptoms
There are many ways to help you manage the symptoms of endolymphatic hydrops. The primary goal in managing your symptoms is to stabilize your body fluids so that there will be no secondary changes in your inner-ear fluid system.

The amount and composition of your inner-ear fluid is affected by the salt and sugar concentrations of your blood and other body fluids. Eating a balanced diet in moderate amounts at regular intervals will ensure that your salt and sugar levels remain fairly constant. You will need to modify your diet to decrease your salt and sugar intake. Your physician or a dietitian will suggest ways to help you accomplish this.

You must be careful to drink an adequate amount of water (5 to 7 glasses per day) and other fluids. It is important that you anticipate and replace large fluid losses that occur during exercise or when it is hot.

Caffeine (coffee, tea, colas, chocolate) and alcohol tend to increase symptoms, so the amounts that you consume should be reduced. Stopping smoking will also be important in controlling your symptoms. You should avoid taking aspirin, any caffeine-containing medications, and over-the-counter medications without first checking with your physician. Your physician may prescribe diuretics as part of your treatment. This is not done to cause you to lose fluids but rather to "push" your kidneys to excrete a constant amount of urine throughout the day, thus helping to minimize big swings in the body's fluid content. You may need to take a potassium supplement along with the diuretic in order to replace potassium lost through urine.

Medications may also be given to help control your dizziness, nausea, and vomiting, if those symptoms are a problem for you.

In some cases, especially when the disease is very severe and restricted to one ear, surgery to relieve the fluid pressure in the inner ear (an "endolymphatic shunt"), or to destroy the inner ear ("labyrinthectomy"), or to disconnect it from the brain ("vestibular neurectomy") may be indicated. Your doctor can tell you whether surgery is indicated in your case.

People diagnosed with Ménière’s disease are thought to have endolymphatic hydrops; however, not all people diagnosed with endolymphatic hydrops have Ménière’s disease.

Sources: National Institute on Deafness and Other Communication Disorders, 2007.