What Are Cochlear Hydrops?
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Cochlear Hydrops: Inner Ear Disorders

Published on Jan 13, 2023 and last reviewed on Jun 29, 2023   -  4 min read


Cochlear hydrops is a condition of the ear affecting the endolymphatic fluid of the cochlea, vestibule, or both. Scroll down to read more.

What Are Cochlear Hydrops?

Cochlear hydrops, also known as endolymphatic hydrops, is a condition of the inner ear affecting the endolymphatic fluid (the fluid within the endolymphatic sac, which is a compartment within the inner ear), cochlea, vestibular apparatus, or both. The exact cause of these conditions is unknown, but it may have resulted from abnormalities in the quantity, composition, or pressure of the endolymph.

In normal conditions, the endolymph is present at an average volume and with a specific concentration of electrolytes like sodium, potassium, chloride, and other electrolytes. This fluid surrounds the sensory cells of the inner ear and allows them to function properly. In cochlear hydrops, this fluid-system control is disrupted or damaged, which causes the volume and concentration of the endolymph to vary according to the changes in the body’s circulatory fluids and electrolytes.

What Are the Types of Cochlear Hydrops?

There are two types of cochlear hydrops. They are:

  1. Primary Cochlear Hydrops- The primary idiopathic cochlear hydrops is also known as Meniere’s disease and occurs for no known reason.

  2. Secondary Cochlear Hydrops- Secondary cochlear hydrops occurs in response to an event such as head trauma allergy or due to underlying conditions such as autoimmune disorders or diabetes.

What Are the Symptoms of Cochlear Hydrops?

The symptoms of cochlear hydrops are:

How Are Cochlear Hydrops Diagnosed?

Diagnosis of cochlear hydrops is mainly made from the clinical presentation by the healthcare provider. The healthcare provider will take a detailed history of the condition and observe the symptoms and symptom patterns based on which the clinician will make the diagnosis. Also, the healthcare provider can advise for tests to support the diagnosis, such as:

  • Electrocochleography- This tests the response of the eighth cranial nerve to the clicks and tones presented to the ear.

  • Audiometry- Audiometry is carried out to test hearing function.

  • MRI (Magnetic Resonance Imaging) Scan- The studies have shown that the MRI scan with contrasts in the inner ear can provide a definitive diagnosis of the cochlear hydrops but will not be able to differentiate the primary or secondary cochlear hydrops.

How Are Cochlear Hydrops Treated?

The treatment of cochlear hydrops is attained by five goals, and they are:

1. Stabilizing the Body’s Fluid and Electrolyte Levels-

Stabilizing the fluid and electrolyte levels helps to reduce or relieve the symptoms of cochlear hydrops, and they can be achieved by modification in diet. The hydrops diet regimen (HDR) has mostly helped the patients get the symptoms improved without any other treatment. The most important aspect of this regimen is to be consistent.

  • Eating a balanced diet at regular intervals, which includes meals and snacks eaten at the same time of the day every day.

  • Minimize the use of solutes such as salt and sugar in the diet. For the dilution and digestion of the solutes, the body requires a large amount of fluid which can result in a significant fluctuation in the body’s fluid and, consequently, the endolymph, which can trigger the symptoms of hydrops. An important step of this diet is to avoid using salt or sugar and avoid canned foods.

  • The other step of this diet regimen is sufficient intake of fluids, but beverages like coffee, tea, aerated drinks, and alcohol have diuretic properties that need to be restricted as they can cause the body to lose more water than intake. Also, the healthcare providers will prescribe diuretics for the treatment so as to reduce the fluid loss and push the kidney to excrete a constant amount of urine throughout the day.

2. Identifying and Treating the Underlying Condition-

This involves both an otologist and a primary healthcare provider to achieve this goal. When the underlying conditions are identified and treated, the symptoms will improve with time and proper management.

3. Improving Daily Symptoms-

By following the hydrops diet regime and the use of diuretics, the balance symptoms will get better gradually. And other symptoms like dizziness, nausea, and vomiting, medications may be prescribed.

  • Maintaining weight and losing the extra weight. When a person is obese, the vestibular system will struggle to deal with a larger-than-normal and displaced center of gravity.

  • Avoiding aspirin in high doses can result in improvement in tinnitus.

  • Avoid medicines such as NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen as they have a direct effect on fluid balance and may increase the symptoms of cochlear hydrops patients.

  • Stop smoking as they constrict the single artery that supplies the ear and thereby deprives it of oxygen and other nutrients.

  • Following a healthy lifestyle, such as daily exercise and following sleep patterns, will improve cardiovascular health and thereby support the inner ear.

  • Vestibular rehabilitation therapy is a type of therapy specialized for vestibular patients. They can improve the tolerance for activity, overall energy level, and symptoms of imbalance and dizziness.

4. Managing Persistent Symptoms and Changes-

If the dizziness and imbalance become severe, medications or surgery can be used to treat the problem.

There are various surgeries, and they are:

  • Endolymphatic Decompression- This surgery aims to relieve the pressure in the inner ear.

  • Labyrinthectomy- It is done to permanently damage or ablate the membranous structure of the inner ear, responsible for detecting gravity and motion changes and hence improving vertigo.

  • Selective or Nonselective Vestibular Neurectomy- This surgery involves cutting the vestibular nerve between the brain and the ear and thereby creating a mechanical barrier that prevents abnormal ear signals from reaching the brain and hence reducing the symptoms.

Cochlear hydrops usually does not cause severe hearing, and if caused, then the patient can use hearing aids and other assistive devices.

5. Maintaining Quality of Life-

Like any chronic disorder, it is important to maintain a healthy outlook and normal routine.


Cochlear hydrops is a condition of the inner ear. This condition can affect the normal living of the patient, and thus, participating in a support group or counseling can help the patient to cope with this condition and help them to overcome the secondary depression and anxiety that accompanies the disease.

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Last reviewed at:
29 Jun 2023  -  4 min read




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