Otolaryngology Book

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Meniere's DiseaseAka: Labyrinthine Hydrops, Endolymphatic Hydrops

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  1. Etiology
    1. Unknown
    2. Exacerbated by stress or emotional disturbance
    3. Associated with concurrent infection in 50% cases
  2. Pathophysiology
    1. Swelling of endolymphatic labyrinthine spaces
    2. Degeneration of the organ of Corti
  3. Symptoms
    1. Prodrome
      1. Headache
    2. Triad
      1. Tinnitus: "Roaring", low tone
      2. Vertigo: Recurrent episodic
      3. Sensorineural Hearing Loss: fluctuant
    3. Usually unilateral
      1. But 33% have bilateral disease
    4. Dizziness
      1. May last minutes to hours, days when severe
  4. Signs
    1. Nystagmus
      1. Only present when Vertigo present
    2. Sensorineural Hearing Loss
      1. Early: Low tones affected
      2. Later: All tones affected
  5. Management: Acute
    1. Diazepam IV
    2. Atropine IV
    3. Transdermal Scopolamine
  6. Management: Maintenance
    1. Medications
      1. Diazepam
      2. Bellergal
      3. Meclizine
    2. Low salt diet (<2 grams daily)
    3. Decrease caffeine
    4. Smoking Cessation
    5. Diuretics (Dyazide)
  7. Management: ENT
    1. Ablation of vestibular hair cells
      1. Performed with intratympanic injection of Gentamicin
    2. Surgery: (10% of patients with refractory cases)
      1. Decompress endolymphatic sacs (Symptom relief in 66%)
      2. Vestibular nerve section (Symptom relief in 95%)
      3. No procedure corrects the Hearing Loss
  8. References
    1. Glasscock (1984) Am J Otol 5:536
    2. Knox (1997) Am Fam Physician 55(4):1185

Endolymphatic Hydrops (C0206586)

Definition (MSH)An accumulation of ENDOLYMPH in the inner ear (LABYRINTH) leading to buildup of pressure and distortion of intralabyrinthine structures, such as COCHLEA and SEMICIRCULAR CANALS. It is characterized by SENSORINEURAL HEARING LOSS; TINNITUS; and sometimes VERTIGO.
ConceptsDisease or Syndrome (T047)
ICD9386.0
EnglishEndolymphatic Hydrops, labyrinthine hydrops
Spanishhidropesía endolinfática, hidropesia endolinfatica
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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