eMedicine Specialties > Neurology > Neuro-otology

Endolymphatic Hydrops: Follow-up

Author: John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
Coauthor(s): Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Contributor Information and Disclosures

Updated: Mar 12, 2009

Follow-up

Further Inpatient Care

Aside from acute control of vertigo and associated effects (eg, dehydration from protracted vomiting), inpatient care is generally unnecessary.

Further Outpatient Care

Vestibular rehabilitation can be helpful in teaching patients to cope with vertigo and imbalance.

Deterrence/Prevention

Dietary control and avoiding trigger substances may prevent acute episodes.

Complications

See Pathophysiology and Causes.

Prognosis

  • Prognosis is variable, since the disease pattern of exacerbation and remission makes evaluation of treatment and prognosis difficult to predict.
    • In general, Ménière symptoms tend to stabilize spontaneously with time. With regard to vertigo, about half of patients stabilize over several years.
    • Patients tend to "burn out" over time and with residual poor balance and hearing.
  • Ménière disease can be classified into several stages of progression. Early stages involve cochlear hydrops, which proceeds to affect the vestibular system.
  • Ménière disease is most bothersome during these early stages.
    • As patients progress to later stages, the hydrops fills the vestibule so completely that no further room is available for pressure fluctuation and the vertigo spells disappear.
    • The acute attacks are replaced by constant imbalance and progressive hearing loss.

Patient Education

 


More on Endolymphatic Hydrops

Overview: Endolymphatic Hydrops
Differential Diagnoses & Workup: Endolymphatic Hydrops
Treatment & Medication: Endolymphatic Hydrops
Follow-up: Endolymphatic Hydrops
Multimedia: Endolymphatic Hydrops
References
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References

  1. Huang W, Liu F, Gao B, Zhou J. Clinical long-term effects of Meniett pulse generator for Meniere's disease. Acta Otolaryngol. Oct 15 2008;1-7. [Medline].

  2. Dornhoffer JL, King D. The effect of the Meniett device in patients with Meniere's disease: long-term results. Otol Neurotol. Sep 2008;29(6):868-74. [Medline].

  3. Mattox DE, Reichert M. Meniett device for Meniere's disease: use and compliance at 3 to 5 years. Otol Neurotol. Jan 2008;29(1):29-32. [Medline].

  4. Silverstein H, Smouha E, Jones R. Natural history vs. surgery for Meniere's disease. Otolaryngol Head Neck Surg. Jan 1989;100(1):6-16. [Medline].

  5. Bretlau P, Thomsen J, Tos M, Johnsen NJ. Placebo effect in surgery for Meniere's disease: nine-year follow-up. Am J Otol. Jul 1989;10(4):259-61. [Medline].

  6. Monsell EM, Wiet RJ. Endolymphatic sac surgery: methods of study and results. Am J Otol. Sep 1988;9(5):396-402. [Medline].

  7. Glasscock ME 3rd, Jackson CG, Poe DS, Johnson GD. What I think of sac surgery in 1989. Am J Otol. May 1989;10(3):230-3. [Medline].

  8. Shea JJ Jr, Ge X. Streptomycin perfusion of the labyrinth through the round window plus intravenous streptomycin. Otolaryngol Clin North Am. Apr 1994;27(2):317-24. [Medline].

  9. Pyykko I, Ishizaki H, Kaasinen S, Aalto H. Intratympanic gentamicin in bilateral Meniere's disease. Otolaryngol Head Neck Surg. Feb 1994;110(2):162-7. [Medline].

  10. Densert B, Sass K. Control of symptoms in patients with Meniere's disease using middle ear pressure applications: two years follow-up. Acta Otolaryngol. Jul 2001;121(5):616-21. [Medline].

  11. Ernst A, Basta D, Seidl RO, et al. Management of posttraumatic vertigo. Otolaryngol Head Neck Surg. Apr 2005;132(4):554-8. [Medline].

  12. Green JD Jr, Blum DJ, Harner SG. Longitudinal followup of patients with Meniere's disease. Otolaryngol Head Neck Surg. Jun 1991;104(6):783-8. [Medline].

  13. Semaan MT, Alagramam KN, Megerian CA. The basic science of Meniere's disease and endolymphatic hydrops. Curr Opin Otolaryngol Head Neck Surg. Oct 2005;13(5):301-7. [Medline].

  14. Shea JJ Jr. Classification of Meniere's disease. Am J Otol. May 1993;14(3):224-9. [Medline].

  15. Silverstein H, Lewis WB, Jackson LE, Rosenberg SI, Thompson JH, Hoffmann KK. Changing trends in the surgical treatment of Meniere's disease: results of a 10-year survey. Ear Nose Throat J. Mar 2003;82(3):185-7, 191-4. [Medline].

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Further Reading

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Keywords

Ménière's disease, Ménière disease, Ménière's syndrome, Ménière syndrome, cochleovestibular hydrops, cochlear hydrops, vestibular hydrops, endolymphatic system, inner ear, dizziness, vertigo, inner ear disorders, endocrine abnormalities, trauma, electrolyte imbalance, autoimmune dysfunction, medications, parasitic infections, hyperlipidemia, endolymph resorption, hearing loss

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Contributor Information and Disclosures

Author

John C Li, MD, Private Practice in Otology and Neurotology; Medical Director, Balance Center
John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society
Disclosure: Nothing to disclose.

Coauthor(s)

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

Medical Editor

Spiros Manolidis, MD, Associate Professor of Otolaryngology and Neurological Surgery, Columbia University
Spiros Manolidis, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Auditory Society, American Head and Neck Society, American Medical Association, Canadian Society of Otolaryngology-Head & Neck Surgery, Society of University Otolaryngologists-Head and Neck Surgeons, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Glenn Lopate, MD, Associate Professor, Department of Neurology, Division of Neuromuscular Diseases, Washington University School of Medicine; Chief of Neurology, St Louis ConnectCare, Consulting Staff, Barnes Jewish Hospital
Glenn Lopate, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Robert A Egan, MD, Director of Neuro-Ophthalmology, St Helena Hospital
Robert A Egan, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, North American Neuro-Ophthalmology Society, and Oregon Medical Association
Disclosure: Nothing to disclose.

 
 
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