Overview
Pathophysiology
Endolymphatic hydrops – an excess of endolymph within the scala media – stretches the Reissner membrane and alters the ionic composition surrounding the hair cells.
Endolymphatic hydrops – an excess of endolymph within the scala media – stretches the Reissner membrane and alters the ionic composition surrounding the hair cells. When the membrane ruptures, potassium‑rich endolymph mixes with sodium‑rich perilymph, transiently depolarising hair cells and vestibular afferents. The resulting ionic imbalance produces the classic triad of episodic vertigo, low‑ to mid‑frequency sensorineural hearing loss (SNHL) and tinnitus. Repeated ruptures lead to irreversible hair‑cell loss, explaining the progressive, permanent component of the hearing deficit.