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Endolymphatic Hydrops

Eye, Ear, Nose and Throat · NLM MeSH · updated 2026-11-04 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

An accumulation of endolymph in the inner ear (labyrinth) leading to buildup of pressure and distortion of intralabyrinthine structures, such as cochlea and semicircular canals.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (745 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

An accumulation of endolymph in the inner ear (labyrinth) leading to buildup of pressure and distortion of intralabyrinthine structures, such as cochlea and semicircular canals. It is characterized by sensorineural hearing loss; tinnitus; and sometimes vertigo.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Hydrops, Endolymphatic.

Where it fits in the MeSH classification

Broader topics
Labyrinth Diseases
Narrower topics
Meniere Disease
See also
Meniere Disease; Transtympanic Micropressure Treatment

Related concepts

  • Endolymph
  • Labyrinth
  • Cochlea
  • Semicircular Canals
  • Sensorineural Hearing Loss
  • Tinnitus
  • Vertigo

Research landscape

PubMed indexes 8,579 records tagged with the MeSH heading “Endolymphatic Hydrops” (counts retrieved 2026-11-04). 1,102 of them (12.8%) were published from 2020 onward, and the busiest period so far is through 1999 with 4,864 records.

Reviews account for 873 records (10.2%) and meta-analyses for 66. Randomized controlled trials number 101 (1.2%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 4,864 records; 2000-2009: 1,210 records; 2010-2019: 1,403 records; 2020 onward: 1,102 records4,864through 19991,2102000-20091,4032010-20191,1022020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19994,864
2000-20091,210
2010-20191,403
2020 onward1,102
Share of records by publication typeReviews: 10.2 percent; Meta-analyses: 0.8 percent; Randomized controlled trials: 1.2 percentReviews10.2% (873)Meta-analyses0.8% (66)Randomized controlled trials1.2% (101)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 8,579 PubMed records
TypeRecordsShare
Reviews87310.2%
Meta-analyses660.8%
Randomized controlled trials1011.2%

Method: PubMed query "Endolymphatic Hydrops"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.

Reading the evidence in eye, ear, nose and throat

Eye, hearing, nose and throat studies rely on specialist tests (visual acuity, eye pressure, audiograms, scopes) and on patient-reported symptoms, which vary between people and with age. Some conditions improve without treatment, so comparison groups matter. Nothing on this page is advice about diagnosis or treatment; sudden loss of sight or hearing needs urgent care from a qualified clinician. Check how the outcome was tested, the age of the people studied and how long they were followed.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière's disease on MRI
Bernaerts A, Vanspauwen R, Blaivie C, van Dinther J, Zarowski A, Wuyts FL, et al.
2019Research article
Design not recorded in structured metadata
171cc by
PMID 30719545 · DOI · PMC6431299
Proinflammatory cytokines and response to molds in mononuclear cells of patients with Meniere disease
Frejo L, Gallego-Martinez A, Requena T, Martin-Sanz E, Amor-Dorado JC, Soto-Varela A, et al.
2018Research article
Design not recorded in structured metadata
88cc by
PMID 29654306 · DOI · PMC5899176
Inner ear pathologies impair sodium-regulated ion transport in Meniere's disease
Eckhard AH, Zhu M, O'Malley JT, Williams GH, Loffing J, Rauch SD, et al.
2019Research article
Design not recorded in structured metadata
77cc by
PMID 30390121 · DOI · PMC6513907
Immunological mechanisms in Meniere's disease
Yuan VG, Xia A, Santa Maria PL
2025Review article
Design not recorded in structured metadata
14cc by
PMID 40936890 · DOI · PMC12420328

The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière's disease on MRI [1]

Research article Bernaerts A, Vanspauwen R, Blaivie C, van Dinther J, Zarowski A, Wuyts FL, et al. · · 2019 · cited 171 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
PurposeThere is still a clinical-radiologic discrepancy in patients with Menière's disease (MD).
Closing excerpt
A four-stage vestibular EH grading system in combination with cochlear PE assessment gives the best diagnostic accuracy to detect MD.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (178 words)

PurposeThere is still a clinical-radiologic discrepancy in patients with Menière's disease (MD). Therefore, the purpose of this study was to investigate the reliability of current MRI endolymphatic hydrops (EH) criteria according to Baráth in a larger study population and the clinical utility of new imaging signs such as a supplementary fourth low-grade vestibular EH and the degree of perilymphatic enhancement (PE) in patients with Menière's disease (MD).MethodsThis retrospective study included 148 patients with probable or definite MD according to the 2015 American Academy of Otolaryngology, Head and Neck Surgery criteria who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI between January 2015 and December 2016. Vestibular EH, vestibular PE, cochlear EH, and cochlear PE were reviewed twice by three experienced readers. Cohen's Kappa and multivariate logistic regression were used for analysis.ResultsThe intra- and inter-reader reliability for the grading of vestibular-cochlear EH and PE was excellent (0.7 ConclusionsMRI using vestibular-cochlear EH and PE grading system is a reliable technique. A four-stage vestibular EH grading system in combination with cochlear PE assessment gives the best diagnostic accuracy to detect MD.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30719545 · DOI · PMC6431299

Proinflammatory cytokines and response to molds in mononuclear cells of patients with Meniere disease [2]

Research article Frejo L, Gallego-Martinez A, Requena T, Martin-Sanz E, Amor-Dorado JC, Soto-Varela A, et al. · · 2018 · cited 88 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Epidemiological studies have found a higher prevalence of allergic symptoms and positive prick tests in patients with Meniere's disease (MD); however the effect of allergenic extracts in MD has not been established.
Closing excerpt
The results indicate that a subset of MD patients have higher basal levels of proinflammatory cytokines and the exposure to Aspergillus and Penicillium extracts may trigger additional TNF-α release and contribute to exacerbate inflammation.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (193 words)

Epidemiological studies have found a higher prevalence of allergic symptoms and positive prick tests in patients with Meniere's disease (MD); however the effect of allergenic extracts in MD has not been established. Thus, this study aims to determine the effect of Aspergillus and Penicillium stimulation in cytokine release and gene expression profile in MD. Patients with MD showed higher basal levels of IL-1β, IL-1RA, IL-6 and TNF-α when compared to healthy controls. We observed that IL-1β levels had a bimodal distribution suggesting two different subgroups of patients, with low and high basal levels of cytokines. Gene expression profile in peripheral blood mononuclear cells (PBMC) showed significant differences in patients with high and low basal levels of IL-1β. We found that both mold extracts triggered a significant release of TNF-α in MD patients, which were not found in controls. Moreover, after mold stimulation, MD patients showed a different gene expression profile in PBMC, according to the basal levels of IL-1β. The results indicate that a subset of MD patients have higher basal levels of proinflammatory cytokines and the exposure to Aspergillus and Penicillium extracts may trigger additional TNF-α release and contribute to exacerbate inflammation.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29654306 · DOI · PMC5899176

Inner ear pathologies impair sodium-regulated ion transport in Meniere's disease [3]

Research article Eckhard AH, Zhu M, O'Malley JT, Williams GH, Loffing J, Rauch SD, et al. · · 2019 · cited 77 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Meniere's disease (MD), a syndromal inner ear disease, is commonly associated with a pathological accumulation of endolymphatic fluid in the inner ear, termed "idiopathic" endolymphatic hydrops (iEH).
Closing excerpt
Overall, we have identified for the first time two inner ear pathologies that are consistently present in MD and can be directly linked to the pathogenesis of EH, and which potentially affect the phenotypical presentation of MD.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (197 words)

Meniere's disease (MD), a syndromal inner ear disease, is commonly associated with a pathological accumulation of endolymphatic fluid in the inner ear, termed "idiopathic" endolymphatic hydrops (iEH). Although numerous precipitating/exacerbating factors have been proposed for MD, its etiology remains elusive. Here, using immunohistochemistry and in situ protein-protein interaction detection assays, we demonstrate mineralocorticoid-controlled sodium transport mechanisms in the epithelium of the extraosseous portion of the endolymphatic sac (eES) in the murine and human inner ears. Histological analysis of the eES in an extensive series of human temporal bones consistently revealed pathological changes in the eES in cases with iEH and a clinical history of MD, but no such changes were found in cases with "secondary" EH due to other otological diseases or in healthy controls. Notably, two etiologically different pathologies-degeneration and developmental hypoplasia-that selectively affect the eES in MD were distinguished. Clinical records from MD cases with degenerative and hypoplastic eES pathology revealed distinct intergroup differences in clinical disease presentation. Overall, we have identified for the first time two inner ear pathologies that are consistently present in MD and can be directly linked to the pathogenesis of EH, and which potentially affect the phenotypical presentation of MD.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30390121 · DOI · PMC6513907

Immunological mechanisms in Meniere's disease [4]

Review article Yuan VG, Xia A, Santa Maria PL · · 2025 · cited 14 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Meniere's disease (MD) is a chronic, relapsing inner ear disorder characterized by episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness.
Closing excerpt
By integrating recent immunological advances with clinical management strategies, we underscore the potential of immune guided approaches to transform the diagnosis, treatment, and long-term care of patients with MD.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (177 words)

Meniere's disease (MD) is a chronic, relapsing inner ear disorder characterized by episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Although its etiology has long remained elusive, accumulating evidence implicates immune dysregulation as a central contributor to disease pathogenesis, particularly in patients who do not respond to standard therapies. This review synthesizes current insights into the immunopathological mechanisms underlying MD, focusing on the roles of both innate and adaptive immune cells-including macrophages, dendritic cells, T cells, and B cells-in promoting inflammation, endolymphatic hydrops, and sensory dysfunction. We examine the contribution of these immune cells to tissue damage, along with the roles of cytokine signaling and immune complex deposition. Emerging immunotherapies, including corticosteroids, biologics, and inflammasome inhibitors, are evaluated for their therapeutic potential. The review also highlights promising directions in precision medicine, such as immune profiling, biomarker discovery, and stratified clinical trials aimed at personalizing treatment. By integrating recent immunological advances with clinical management strategies, we underscore the potential of immune guided approaches to transform the diagnosis, treatment, and long-term care of patients with MD.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40936890 · DOI · PMC12420328

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Diagnostic criteria for Menière's disease [5]
    Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandalà M, et al. · J Vestib Res · 2015 · cited 1,027 times (Europe PMC)
  • Research article Meniere's disease [6]
    Sajjadi H, Paparella MM · Lancet · 2008 · cited 340 times (Europe PMC)
  • Research article Meniere's disease [7]
    Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, et al. · Nat Rev Dis Primers · 2016 · cited 245 times (Europe PMC)
  • Research article Clinical Practice Guideline: Ménière's Disease [8]
    Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R, et al. · Otolaryngol Head Neck Surg · 2020 · cited 226 times (Europe PMC)
  • Research article Neurotology of migraine [9]
    Baloh RW · Headache · 1997 · cited 160 times (Europe PMC)
  • Research article What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops [10]
    Gürkov R, Pyykö I, Zou J, Kentala E · J Neurol · 2016 · cited 157 times (Europe PMC)

References

  1. Bernaerts A, Vanspauwen R, Blaivie C, van Dinther J, Zarowski A, Wuyts FL, et al.. The value of four stage vestibular hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menière's disease on MRI. . 2019. PMID 30719545 · DOI · PMC6431299
  2. Frejo L, Gallego-Martinez A, Requena T, Martin-Sanz E, Amor-Dorado JC, Soto-Varela A, et al.. Proinflammatory cytokines and response to molds in mononuclear cells of patients with Meniere disease. . 2018. PMID 29654306 · DOI · PMC5899176
  3. Eckhard AH, Zhu M, O'Malley JT, Williams GH, Loffing J, Rauch SD, et al.. Inner ear pathologies impair sodium-regulated ion transport in Meniere's disease. . 2019. PMID 30390121 · DOI · PMC6513907
  4. Yuan VG, Xia A, Santa Maria PL. Immunological mechanisms in Meniere's disease. . 2025. PMID 40936890 · DOI · PMC12420328
  5. Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandalà M, et al.. Diagnostic criteria for Menière's disease. J Vestib Res. 2015. PMID 25882471 · DOI
  6. Sajjadi H, Paparella MM. Meniere's disease. Lancet. 2008. PMID 18675691 · DOI
  7. Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, et al.. Meniere's disease. Nat Rev Dis Primers. 2016. PMID 27170253 · DOI
  8. Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R, et al.. Clinical Practice Guideline: Ménière's Disease. Otolaryngol Head Neck Surg. 2020. PMID 32267799 · DOI
  9. Baloh RW. Neurotology of migraine. Headache. 1997. PMID 9439080 · DOI
  10. Gürkov R, Pyykö I, Zou J, Kentala E. What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops. J Neurol. 2016. PMID 27083887 · DOI · PMC4833790

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-11-04.

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At a glance

8,579
PubMed records on this heading
13%
published since 2020
873
review articles
101
randomized trials
10
verified references below

Counts come from PubMed on 2026-11-04; they show how much has been written, not how strong the evidence is.

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