Secondary Endolymphatic Hydrops

Endolymphatic hydrops may be either primary or secondary. Primary idiopathic endolymphatic hydrops—known as Meniere's disease—occurs for no known reason. Secondary endolymphatic hydrops appears to occur in response to an event or underlying condition. For example, it can follow head trauma or ear surgery, and it can occur with other inner ear disorders, allergies, or systemic disorders (such as diabetes or autoimmune disorders).

Although the underlying cause of endolymphatic hydrops is unknown, it is believed to result from abnormalities in the quantity, composition, and/or pressure of the endolymph, the fluid within the inner ear. Symptoms typical of endolymphatic hydrops include pressure or fullness in the ears, tinnitus (ringing or other noise in the ears), hearing loss, dizziness, and imbalance.

The diagnosis of endolymphatic hydrops is clinical—based on the physician's observations and on the patient's history, symptoms, and symptom pattern. The clinical diagnosis may be strengthened by the results of certain tests, including electrocochleography (ECoG) or audiometry.

Meniere's disease is characterized by sudden, violent attacks or episodes of vertigo, tinnitus, hearing loss, and aural fullness. Since secondary endolymphatic hydrops (SEH) results from an underlying disorder, the symptoms tend to be present more continuously, rather than occurring in spontaneous attacks. However, they are often less violent, and SEH may cause less damage to hearing and balance than does Meniere's disease.

A hydrops diet regimen—which emphasizes eating a balanced diet in moderate amounts at regular intervals, minimizing the use of salts and sugars, and taking in plenty of fluids—often makes many people with SEH feel significantly better. A physician may prescribe diuretics. Other medications may be used to help with persistent dizziness, nausea, or vomiting.

Vestibular rehabilitation, a type of specialized physical therapy, can improve tolerance for activity, overall energy level, and symptoms of dizziness and imbalance. If dizziness and vertigo become intractable, the hair-cell structures of the inner ear may be selectively destroyed with the careful use of ototoxic (ear-poisoning) medication. In rare cases, surgery may be recommended.

From VEDA publication F-2, Secondary Endolymphatic Hydrops