Endolymphatic Hydrops

Endolymphatic hydrops is a condition that develops as a result of increased hydraulic pressure of the inner ear fluid called endolymph. This endolymph fluid is constantly absorbed and produced to maintain the normal level of balance. When the pressure increases, the endolymphatic membranes become dilated representing a balloon, this is called the hydrops. Along with water, endolymph fluid consists of sodium, potassium, chloride and other electrolytes. The symptoms of this disorder may develop when there is a change in the quantity of endolymph fluid as a result of an injury or disorder. The endolymphatic hydrops is also associated with Meniere disease and Meniere syndrome, which are the result of increased pressure within the endolymphatic system. There are two types of this disorder, the primary and secondary. The primary endolymphatic hydrops, also known as Meniere’s disease, develops from the unknown cause. The secondary endolymphatic hydrops develops as a result of an event such as allergy, head trauma or autoimmune disorder.


The accumulated pressure within the endolymphatic system can create symptoms such as hearing loss, vertigo, ringing sound, pressure or fullness in the ears and balance problems. Several episodes of attack may develop within a short period of time or alternatively years may pass between the episodes. Generally, the symptoms may affect the single ear and about 75% of the affected individuals are prone to develop this disorder in both ears within 5 years.


Endolymphatic hydrops usually develops as a result of a condition such as degeneration of the inner ear, loss of electrolytes, dehydration and benign tumor. In most individuals, the causes are not clear. Meniere’s disease is thought to develop due to the obstruction of the endolymph fluid. This can be due to the increase in the fluid production or decrease in absorption because of the dysfunction of the endolymphatic sac. The other disorders that affect the endolymphatic pressure include hormonal imbalance, metabolic disturbances and various infections.

Diagnosis and Treatment

Endolymphatic hydrops is diagnosed by the ENT specialist based on the individual’s medical history and symptoms. Generally, standard audiometric testing will diagnose the hearing loss of individuals with aural problems. Other tests include electrocochleography (ECoG) which records the electrical information of the inner ear and auditory nerve when sound is stimulated.

The treatment involves the management of the symptoms such as keeping hydrated or a maintaining a diet with low salt and sugar intake. Medications are administered to control the symptoms such as nausea, vomiting and dizziness. Depending on the severity of the case, an inner ear surgery will be performed to relieve the symptoms.