Endolymphatic Hydrops: Fluid Volume Excess
Endolymph overaccumulates inside the inner ear's membranous labyrinth.
- Endolymph: Affected compartment (scala media fluid)
- Impaired resorption: Driving mechanism (endolymphatic sac dysfunction)
- ↑ Excess: Volume change (relative to perilymph)
- Gradual: Onset pattern (builds over time)
Fluid volume buildup
Placeholder: endolymph volume rises as production exceeds resorption capacity.
Membrane Distension and Hair Cell Pressure
Swollen fluid compartment stretches membranes against sensory hair cells.
- Reissner's membrane: Structure stressed (separates scalae)
- Distension: Mechanical effect (bulging under pressure)
- Compression: Hair cell impact (mechanotransduction disrupted)
- Partial: Reversibility (early stages)
Membrane stress
Placeholder: pressure bulges the membrane, pressing on delicate hair cell bundles.
The Vertigo-Tinnitus-Hearing Loss Triad
Hair cell disruption produces the hallmark three-symptom pattern.
- Episodic: Vertigo (vestibular hair cell stress)
- Ringing: Tinnitus (cochlear irritation)
- Low-frequency: Hearing loss (fluctuating early on)
- Aural pressure: Fullness (often co-occurs)
Triad mechanism
Placeholder: shared fluid pressure disrupts vestibular and cochlear hair cells together.
Episodic, Fluctuating Symptom Course
Symptom intensity fluctuates unpredictably across repeated attacks.
- 20min–24h: Attack duration (typical episode)
- Fluctuating: Pattern (remission between attacks)
- Variable: Progression (unpredictable long-term course)
- Multifactorial: Triggers (salt, stress, fatigue)
Episodic course
Placeholder: attacks recur intermittently with symptom-free intervals between.
Low-Salt Diet for Fluid Management
Reducing sodium intake helps lower endolymph fluid pressure.
- Low-salt diet: Intervention (first-line management)
- <1500-2000mg/day: Target sodium (typical guidance)
- Fluid reduction: Mechanism (less endolymph retention)
- Symptom relief: Outcome (reduced attack frequency)
Dietary sodium restriction
Placeholder: lowering salt intake reduces fluid retention and eases pressure.
Placeholder: low-salt diet is a simple, evidence-supported first step in management.