遲發性 内淋巴水腫

Delayed endolymphatic hydrops(DEH), a clinical entity which was described as a syndrome with the characteristic clinical findings such as rotatory vertigo or fluctuating hearing loss on the normal ear appearing a few years after unilateral severe sensori-neural hearing loss or total deafness.

DEH can be differentiated from Meniere’s disease, and was first reported simutaneously by Nadol et al and Wolfson et al in 1975, and was specified by Schuknecht in 1978.

Schuknecht, in 1985, classified DEH into 3 types ; 1) ipsilateral : rotatory vertigo only, 2) contralateral: rotatory vertigo with fluctuating hearing loss on the normal side, and 3) bilateral.

In many cases the hearing loss was caused by juvenile unilateral total deafness of unknown causes, viral diseases such as mumps, other postinflammatory or posttraumatically.

There is no tendency of rule in latency between hearing loss and vertigo or fluctuating hearing loss on opposite ear, and it is more than 10 years in many cases.

Diagnosis is made from history, clinical findings, audiologic and equilibrium function test.

Treatment is similiar to that of Meniere’s disease with conservative (vasodilators, autonomic nerve controlling drugs, steroid, antivertiginous drugs, low salt diet, etc) and surgical method (endolymphatic sac surgery or labyrinthine destruction) in case of no effect by conservative. But, in general, the result of treatment is poorer than in Meniere’s disease.