Learn the Causes, Symptoms, and Misdiagnosis of Cochlear Hydrops
Introduction
Dr. R. Brad Culberson, MD of the Ear, Nose and Throat Center of South Denver, Littleton and Highlands Ranch defines cochlear hydrops as an inner ear disorder, where the patient has hearing loss, fullness and tinnitus (ringing in the ear), but no vertigo symptoms. Comparatively, the Mayo Clinic states that Meniere’s disease has all the symptoms of cochlear hydrops, including vertigo. Professionals debate whether cochlear hydrops is a form of Meniere’s disease; others debate if cochlear hydrops will develop into Meniere’s disease, with the additional symptom of vertigo.
Causes of Symptoms
Cochlear hydrops are caused by an accumulation of fluid in the inner ear. Dr. Culberson states that Meniere’s disease has excess fluid in the cochlear (hearing) part and the vestibular (balance) part of the inner ear; cochlear hydrops have the fluid only in the cochlear portion of the inner ear, resulting in the absence of vertigo symptoms. The apex of the cochlear portion of the inner ear is more sensitive to the pressure changes from fluid accumulation; as a result, patients have low tone ringing (tinnitus), fluctuating hearing loss, and pressure, discomfort, and fullness sensation in the ear (aural fullness).
Progression of Symptoms
The symptoms of cochlear hydrops are developed over several years. Dr. Culberson states that symptoms begin with tinnitus, which he adds “can follow an episode of loud noise exposure with the onset of tinnitus.” After a few years, the patient develops a “fullness” feeling, in which she feels like her ear is clogged. However, the ringing and fullness are not constant symptoms. Dr. Culberson states that patients have “clear” days, in which the fullness in the ear is alleviated. This is followed by a temporary cessation of tinnitus. Thus, cochlear hydrops patients enter a symptom pattern of ringing and fullness in the ear, then clearing of the fullness, then dissipation of the ringing, and then restarting the ringing and fullness symptoms. The Mayo Clinic notes that the symptoms usually occur in only one ear.
Cochlear hydrops patients can get temporary relief by performing a “big yawn” or the valsalva maneuver, in which the patient uses “a forced expiratory effort against a closed glottis (windpipe) that decreases intrathoracic pressure, hampering venous return to the heart, and that can be used to inflate the Eustachian tubes and adjust pressure in the middle ear,” according to Dictionary.com. However, Dr. Culberson notes that the relief last only half a second, with the fullness in the ear returning.
Misdiagnosis
Cochlear hydrops can be mistaken for eustachian tube dysfunction, which is also known as ear barotrauma. The National Institutes of Health (NIH) states that eustachian tube dysfunction is “discomfort and possible damage in the ear due to pressure differences between the inside and outside of the eardrum.” When misdiagnosed, Dr. Culberson states that the eustachian tube dysfunction treatments (steroids, antihistamines, decongestants and placement of myringotomy tubes) do not provide any benefits for cochlear hydrops patients.
