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Secondary Endolymphatic Hydrops

What Is Secondary Endolymphatic Hydrops?

Secondary endolymphatic hydrops, or SEH, is a problem with the fluid in the inner ear. Your inner ear helps control hearing and balance. It has fluid inside it called endolymph. In SEH, there may be too much fluid, too much pressure, or a change in the normal salt and mineral levels of this fluid.

SEH happens because of another condition or event. It may happen after a head injury, ear surgery, another inner ear problem, allergies, diabetes, or an autoimmune disorder. This is different from Ménière’s disease, which is called primary endolymphatic hydrops. 

What is Happening in My Body?

Think of your inner ear like a motion sensor or a level tool. It helps your brain know when your head is moving and where your body is in space. When the inner ear fluid is not balanced, the motion sensor may send mixed signals to the brain. This can affect hearing, balance, and how steady you feel.

Because of this, you may feel:

  • Dizziness
  • Vertigo
  • Tinnitus
  • Hearing changes
  • Ear fullness
  • Ear pressure
  • Unsteadiness
  • Imbalance

It is important to know:

  • Your symptoms are real.
  • SEH can often be managed or treated.
  • Finding the cause is an important part of treatment.
  • Tell your provider about new or changing symptoms as soon as possible.

How is Secondary Endolymphatic Hydrops Diagnosed?

SEH is diagnosed by a trained provider. Your provider will listen to your symptoms and health history. There is no single simple test that confirms SEH in every person.

Some tests may help support the diagnosis or rule out other causes. These may include:

What Your Provider May Ask

To gain a better understanding of your symptoms, you provider may ask you questions about them. To prepare for this, it could be helpful to think about, and even write down, your answers to the following questions.

You provider might ask:

  • When did your symptoms start?
  • How long do your symptoms last?
  • Do your symptoms come and go, or are they there most of the time?
  • Do you have hearing loss?
  • Do you have ringing, buzzing, or roaring in your ear?
  • Do you feel ear fullness or pressure?
  • Have you had a head injury?
  • Have you had ear surgery?
  • Do you have diabetes, allergies, or an autoimmune disease?
  • Do you feel unsteady when walking?
  • Do you feel spinning, rocking, or tilting?

How is Secondary Endolymphatic Hydrops Treated?

Treatment depends on the cause and your symptoms. Your provider may use one or more of these steps.

1. Help keep body fluid levels steady

Your provider may suggest:

  • Eating meals at regular times
  • Drinking enough water during the day
  • Replacing fluids after exercise, sweating, or illness
  • Limiting salt or added sugar, if recommended
  • Reducing caffeine or alcohol, if these trigger symptoms
  • Taking a diuretic, or water pill, if prescribed
  • Taking potassium only if your provider says it is needed

2. Find and treat the cause

SEH happens because of another issue. Treatment may focus on the cause, such as a head injury, ear surgery, allergy, diabetes, autoimmune disease, or another inner ear problem.

3. Improve daily symptoms

Your provider may suggest:

  • Vestibular therapy
  • Regular sleep
  • Regular exercise, as tolerated
  • Stopping smoking
  • Avoiding high doses of aspirin unless your provider tells you to take it
  • Talking with your provider before frequent use of NSAIDs, such as ibuprofen or naproxen

4. Treat symptoms that do not improve

Some people need medicine for dizziness, nausea, or vomiting. In severe cases that do not improve, a specialist may discuss other treatments. Surgery is only used in select cases.

5. Support quality of life

Living with dizziness can be frustrating. Counseling, education, support groups, and safety changes at home may help.

What Can I Expect Over Time?

Will I Get Better?
Many people improve when the cause is found and treated. Symptoms may not go away right away, but they can often be managed.

How Long Will It Take?
Getting the right diagnosis may take time. Once treatment starts, many people begin to feel better. SEH after head injury or ear surgery may take longer to improve.

Can I Live a Normal Life?
Yes. Many people can live a normal life with the right care. Some people may need changes to their diet, activity, or daily routine.

When Should I Call My Provider?

Call your provider if your dizziness, hearing, ear pressure, or balance symptoms are new, worse, or changing.

Seek urgent medical care right away if you have:

  • New weakness or numbness
  • Trouble walking
  • Trouble speaking
  • Double vision
  • A severe or “worst ever” headache
  • Fainting
  • Chest pain
  • Vertigo that is constant or getting worse
  • Sudden new hearing loss
  • Repeated vomiting
  • A fall with a head injury

Questions to Ask Your Provider

To learn more about your symptoms and prepare for any future treatment, it may be helpful to ask your provider questions.

You could ask:

  • Do I have hearing loss?
  • What may be causing my dizziness?
  • What may be causing my imbalance?
  • Could another condition be causing these symptoms?
  • What can I do to improve my dizziness and balance?
  • Do I need vestibular therapy?
  • Do I need medicine?
  • Do I need more testing?
  • Do I need to see an ear specialist?

Key Points to Remember

  • SEH is a problem with the fluid in the inner ear.
  • It can affect hearing and balance.
  • It happens because of another condition or event.
  • Possible causes include head injury, ear surgery, allergies, diabetes, autoimmune disease, or another inner ear problem.
  • Treatment focuses on finding the cause, managing symptoms, and improving daily life.
  • Many people improve with the right care.

Additional Resources