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Endolymphatic Hydrops

1. What is endolymphatic hydrops?

Endolymphatic hydrops is a disorder of the vestibular system, which is part of the inner ear. Endolymphatic hydrops consists of abnormal fluctuations in the endolymph fluid, which fills the hearing and balance structures of the inner ear. These fluctuations cause an increase in pressure in the endolymphatic system of the inner ear. Endolymph fluid, which is regulated by the endolymph sac, flows through the inner ear and is critical to hearing. In addition to water, endolymph fluid contains salts such as sodium, potassium, chloride and other electrolytes. If the inner ear is damaged by disease or injury, the volume and composition of the endolymph fluid can also change, causing the symptoms of endolymphatic hydrops.

2. Symptoms of endolymphatic hydrops?

The symptoms of endolymphatic hydrops include the feeling of pressure or fullness in the ears, hearing loss, tinnitus, (ringing in the ears), hearing loss, and balance problems. Individuals who have Meniere’s disease have a very severe form of endolymphatic hydrops, but individuals with endolymphatic hydrops do not always progress to Meniere’s disease.

3. What are the causes of endolymphatic hydrops?

Endolymphatic hydrops may occur as a result of trauma such as a blow to the head, infection, degeneration of the inner ear, allergies, dehydration and loss of electrolytes or in rare circumstances a benign tumor. In many cases, it is not clear what causes the disorder. Meniere’s attacks occur when there is an increase in endolymphatic pressure in the inner ear, causing a leak in the membrane separating the perilymph (potassium poor extracellular fluid) and the endolymph (potassium rich intracellular fluid). The mix of these two fluids surrounding the vestibular nerve receptors creates an electrical blockade and a loss of function. The sudden change in the rate of the vestibular nerve firing creates acute vestibular imbalance otherwise known as vertigo.

4. What is the treatment for endolymphatic hydrops?

A specialized interdisciplinary team of professionals is necessary to treat all of the issues associated with Endolymphatic hydrops. This group of individuals should include an Otologist or Otolaryngologist, and an audiologist, and possibly a vestibular rehabilitation expert.

Over our forty-year history, CEI neurotologists have developed and refined a three level treatment strategy for patients with Endolymphatic hydrops. The three levels begin with dietary and lifestyle modifications, then medication, and in some cases, a physical therapy and exercise program. In those patients who fail to respond to first measures, more aggressive treatment is needed and may include surgery to stop the attacks of vertigo. Over 90 % of CEI patients successfully have their vertigo controlled with this strategy.

The California Ear Institute is a leading global center for otological, otolaryngological and audiological treatment. Dr. Joseph Roberson, a board certified neurotologist, has performed thousands of successful hearing related surgeries, including many on patients whose hearing impairment is the result of Endolymphatic hydrops.

5. What are the consequences of avoiding treatment?

Patients must seek medical treatment for any change in hearing or balance regardless of whether or not Endolymphatic hydrops is suspected to be the source of the hearing loss. Evaluation for beneficial drug treatment or surgery cannot be established without a comprehensive medical examination and associated testing. Avoiding medical evaluation for Endolymphatic hydrops or any other hearing or balance impairment related condition is not recommended, and can lead to permanent hearing loss.

Additional Notes

Patients searching the internet for information about Endolymphatic hydrops or any other medical issue should know when reading about individual case histories, that generally it is the patients with the most severe symptoms who either post their own experiences or are included in medical review journals. As a result, it is easy to become overly alarmed and assume the worst. Patients should keep this in mind as they explore the available resources, and look for sources that are certified by HON or other reputable health reviewing organizations. As with all medical conditions, prompt treatment by experienced medical personnel give the best chance for a positive outcome.


If you suspect that you have Endolymphatic Hydrops, or you have noticed a change in your hearing, consult a CEI otologist. The outlook for treatment is excellent, once the diagnosis has been made and appropriate treatment is initiated.

Click here to make an appointment with the California Ear Institute to consult with one of our board certified otologists regarding your ear-related condition.

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