What is delayed endolymphatic hydrops?

summary

Delayed endolymphatic hydrops is a disease similar to Meniere's disease but with definite etiology. Nadol et al. Reported for the first time in 1975. Schuknecht described its classification and nomenclature comprehensively in 1978. DEH refers to patients with severe sensorineural hearing loss in one ear, and then with ipsilateral or contralateral membranous labyrinthine hydrops. The interval from the occurrence of deafness to the occurrence of membranous labyrinthine hydrops can be as long as several decades.

What is delayed endolymphatic hydrops?

DEH is a kind of independent disease which is different from Meniere's disease. Meniere's disease is also known as idiopathic endolabyrinthine hydrops. It is accompanied by vertigo symptoms such as nausea and vomiting, tinnitus, fluctuating hearing loss and ear tightness. It usually occurs in the middle-aged people aged 30-50 years old. Few patients have severe sensorineural hearing loss as the first symptom.

Meniere's disease is more common than DEH. DEH usually occurs in patients with previous ear pathological damage. Because of the damage of endolymphatic sac or blockage of vestibular aqueduct, it damages the endolymphatic absorption system and eventually leads to DEH. DEH was named by schuknecht et al. (1978) and divided into ipsilateral and contralateral types. Ipsilateral type refers to the occurrence of vertigo similar to Meniere's disease in the ipsilateral ear after severe sensorineural hearing loss; Contralateral type refers to severe sensorineural hearing loss in one ear, after several years to decades of incubation period, Meniere's disease symptoms appear in the contralateral ear.

Conservative treatment: general use to regulate autonomic nerve function (sedative), improve inner ear microcirculation (vasodilator), relieve labyrinthine hydrops as the main purpose of comprehensive treatment, attack period should be bed rest, choose high protein, high vitamin, low fat, low salt diet. Gradually get out of bed after symptom relief.

matters needing attention

Surgical treatment: frequent and severe vertigo, ineffective conservative treatment, severe tinnitus and deafness, surgical treatment can be considered. There are many operative methods, which are usually destructive. The less destructive one should be chosen carefully. Endolymphatic drainage, labyrinthine destruction, partial or complete resection of cochlea and vestibular nerve are commonly used.