What is Endolymphatic Hydrops?
Endolymphatic hydrops is a condition in which the fluid balance in the inner ear is disturbed. This can occur as a result of inner ear inflammation, trauma, or for unclear reasons. Endolymphatic hydrops resulting from unclear reasons is called Meniere’s disease.
Symptoms Associated with Meniere’s disease
Most patients with Meniere’s disease will have several or all of the following symptoms: vertigo (dizziness characterized by an abnormal sense of motion such as spinning), hearing loss on one side that may increase and decrease over time, fullness of the ears, and tinnitus (ringing, buzzing, or other abnormal internal sound sensations). The symptoms can spontaneously improve for weeks, months, or even years, but the symptoms can return over time. Symptoms can also be triggered by various factors such as stress, allergy attacks, and salt ingestion.
What is the Evaluation Process?
Patients with dizziness and hearing loss undergo a full ear, nose and throat evaluation. In addition, they may be given a hearing test to produce an audiogram, a balance (vestibular) test such as an ENG or VEMP or image test such as a MRI or CT scan. Based on the medical evaluation, the treatment options for the dizziness and hearing loss will be presented to you.
Treatment for Hearing Loss and Tinnitus in Meniere’s Disease
The hearing loss associated with Meniere’s Disease is sensorineural hearing loss which cannot be corrected surgically. Hearing aids are typically the main treatment option. These devices now employ modern programmable electronics that make them function much better than older aids that are not programmable. Hearing aids typically allow patients to hear better, and they reduce the sensation of tinnitus. Patients whose hearing is so severe that hearing aids are not useful may be candidates for the cochlear implant.
Treatment for Dizziness in Meniere’s Disease
Most cases of Meniere’s dizziness respond well to treatment with low salt diet, avoidance of triggering factors (i.e. stress) or treatment of triggering factors (i.e. allergy), and a diuretic medication. The few patients who do not respond well to these conservative treatments may undergo additional treatments. These include office procedures such as intratympanic steroid or gentamicin injection, and surgical treatments such as endolymphatic sac surgery, labyrinthectomy, and vestibular nerve section. Very few patients currently require surgical treatment due to the success of the office procedures.