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.