Clinical Findings of Delayed Endolymphatic Hydrops

Abstract

Schuknecht (1985) classified delayed endolymphatic hydrops (DEH) into three types, ipsilateral, contralateral and bilateral. The concept of DEH has been generally accepted; however, there is a problem that contralateral DEH might be unilateral Meniere's disease, accidentally appearing in on the ear opposite to that with severe deafness. In this paper the characteristics of contralateral DEH are compared with ipsilateral DEH and unilateral Meniere's disease.In the past 9 years 20 patients with DEH, 10 ipsilateral and 10 contralateral, were selected from among all the patients who had visited our clinic in the same period for a retrospective investigation of unilateral and bilateral severe deafness. Patients with unilateral Meniere's disease in the ear opposite to that with early onset of severe deafness, were included in the contralateral DEH. Three cases with contralateral DEH had no vertigo or dizziness with fluctuating hearing loss. Four patients with contralateral DEH had episodic vertigo; sensorineural hearing loss, which was of sudden onset in three, appeared from one to 10 years before the fluctuating hearing loss. Thus, in seven patients with contralateral DEH, cochlear disorders were the only symptom of DEH or preceded the onset of DEH. This tendency is different from the nature of the onset of Meniere's disease. In six of the nine patients with contralateral DEH (66%), endolymphatic hydrops was detected by the glycerol test, the ECochG and/or the furosemide VOR. Because not all patients were tested with all three examinations, the percentage of those with endolymphatic hydrops was lower than in those with Meniere's disease in our clinic (90%). In the four patients, who were tested with all three examinations, however, endolymphatic hydrops were demonstrated, There-fore we concluded that the number of findings pointing to endolymphatic hydrops in contralateral DEH was not very different from that in Meniere's disease.These results suggest that the characteristics of contralateral DEH may be different from those of Meniere's disease although both diseases have the same pathogenesis : endolymphatic hydrops.