Endolymphatic or cochlear hydrops

What is endolymphatic or cochlear hydrops?

Endolymph is a liquid contained in the membranous labyrinth of the inner ear, especially in the cochlea, and in the system responsible for maintaining balance (semicircular canals, utricle and saccule).

Causes and symptoms

If formation, flow and reabsorption of endolymph are altered, this can lead to dysfunctions in the auditory and vestibular system. An excessive accumulation of endolymph, defined hydrope, at the level of the cochlea and the vestibular system causes an increase in endolymphatic pressure which can produce micro-lesions in the membranous labyrinth.

All this can be completed in what is identified as Ménière's disease, a pathology characterized by dizziness, a feeling of clogged ear, tinnitus and fluctuating hearing loss. Endolymphatic hydrops can manifest itself as full-blown Ménière's disease or give intermediate forms characterized by imbalance without hearing loss or only fluctuating hearing loss with ear fullness.

Treatment of endolymphatic hydrops

In the treatment of endolymphatic hydrops, the objectives to be pursued are:

  • The reduction in the number and severity of dizziness episodes
  • Control of hearing loss and tinnitus associated with vertigo episodes
  • Iimprovement of instability and other symptoms
  • Prevention of attacks and progression of the disease

To date, two different approaches can be distinguished for the treatment of cochlear hydrops:

  1. Treatment of the acute phase: the therapeutic strategy aims to reduce dizzying symptoms, control endolymphatic hydrops, reduce hearing loss and the perception of tinnitus. In this phase, the most commonly used drugs are: vestibule-suppressants, diuretics, cortisones, antihistamines.
  2. Treatment of chronic disease: when it is not possible to control the course of the disease, the toxic vestibule action peculiar to some antibiotics such as streptomycin and gentamicin is used. Intrathympanic administration determines excellent results with a risk of developing deafness equal to 20%. Since there is the possibility of developing bilateral Méniere's disease, this type of treatment must be carefully evaluated.

In case of failure of all therapeutic approaches, which is rare, it is possible to intervene in the treatment of Ménière's disease with surgery.

In general, all patients with symptoms such as to lead the phenomenon to endolymphatic hydrops are advised to change their lifestyle and are given food restrictions. The diet consists in eliminating foods with a high concentration of salt, caffeine, alcohol and super-alcoholic beverages, chocolate and smoking and it is necessary to lead a less stressful life and avoid excessive physical fatigue.

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