I have bilateral sensorineural hearing loss, and my vestibular aqueduct is small. Is it cochlear hydrops?

Question

Hi doctor,

I wear two hearing aids for bilateral sensorineural hearing loss for four to five years, which has fluctuated in upper and lower frequency over the years. Other symptoms include aural fullness (two episodes over a year ago). Prednisone was prescribed, and hearing slowly returned in five to seven days. ENT suspected clogged eustachian tube. Then was referred to another ENT who suspected cochlear hydrops due to fluctuating frequency. I do not have tinnitus, vertigo, or migraine. I was put on a low salt, no caffeine, and migraine diet for six months. Three months in, and there is no hearing improvement. MRI of IAC was normal, CT of temporal bone showed small or not seen vestibular aqueducts. My C-reactive protien is normal. Does a small vestibular aqueduct always indicate cochlear hydrops or Meniere's disease? Is a six-month diet necessary to see improvement? Should I be able to feel improvement by now? Please guide me.

Answer 1

Hello,

Welcome to icliniq.com.

The small vestibular aqueduct is an anatomical finding that does not detail whether there is an increased production of the endolymph or its reduced excretion. For this, we need to do a pure tone audiogram and, more importantly, SISI (short increment sensitivity index) or electrocochleography. These tests are available only in ENT (ear, nose, and throat) centers dedicated to vertigo or inner ear pathology. My initial guess with your symptom profile is that you could be having hydrops (cochlear, vestibular, or both), and I suggest treatment with intratympanic steroid injections. These injections are given over a week daily in the affected ear. I also suggest taking a combination of medicines that increase blood circulation inside the inner ear, reduce the endolymph fluid production, and improve nerve functioning. Please get back for further queries.