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Description
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.
Source: National Institute on Deafness & Other
Communication Disorders, 2000.
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