DELAYED ENDOLYMPHATIC HYDROPS - CLINICAL MANIFESTATIONS AND TREATMENTOUTCOME

The clinical entity of delayed endolymphatic hydrops was first defined by Schuknecht in 1978. It constitutes the development of symptoms con sistent with endolymphatic hydrops either ipsilateral or contralateral to an ear with a profound hearing loss. We report our experience with this condition amongst 394 patients with Meniere's syndrome followed prospectively. Of 24 patients with the ipsilateral condition, nearly h alf responded to medical treatment. Thirteen patients underwent vestib ular nerve section and the outcome, as assessed by a disability gradin g system, was very satisfactory. The proportion of patients undergoing vestibular nerve section (54.9%) was substantially higher than patien ts with classical Meniere's syndrome during the same period (5.4%) ref lecting the increased severity of the symptoms, The contralateral form was less frequently seen and patients were more refractory to treatme nt. The audiological definition of delayed endolymphatic hydrops appea rs somewhat arbitrary, as these patients form a continuous spectrum wi th other Meniere's syndrome cases, occurring in association with less marked degrees of sensorineural hearing loss.