Inner Ear Imbalance

What is Ear Fluid Imbalance?

Ear Fluid Imbalance (also known as inner ear fluid imbalance or endolymphatic hydrops) refers to an abnormal production or absorption of the fluid (endolymph) inside the inner ear, causing pressure imbalance in the inner ear. This affects both balance and hearing functions. The inner ear is a critical structure for maintaining balance and processing sound; when its fluid regulation or structure is disrupted, it can trigger a range of distressing symptoms such as vertigo, tinnitus, and hearing loss.
 

“Ear fluid imbalance” is not a specific disease name but a descriptive term for symptoms commonly seen in several inner ear disorders, with Ménière’s Disease being the most typical example. If left untreated, it can significantly interfere with daily life.
 

Causes of Ear Fluid Imbalance

The condition is usually related to abnormalities in the endolymph (inner ear fluid). Common causes include:
 

1. Ménière’s Disease
   A chronic inner ear disorder caused by accumulation of endolymph, leading to increased inner ear pressure.
    

2. Inner ear infections
   Viral or bacterial labyrinthitis that disrupts fluid balance.
    

3. Head trauma
   Injury to the head that damages inner ear structures, causing leakage or abnormal absorption of endolymph.
    

4. Allergic reactions
   Allergies can trigger inflammation in the inner ear and interfere with normal fluid circulation.
    

5. Autoimmune diseases
   Certain autoimmune conditions may attack inner ear tissues, affecting fluid regulation.
    

6. Stress or hormonal changes
   Prolonged stress, lack of sleep, or hormonal fluctuations can influence inner ear function and trigger imbalance.
    

Symptoms of Ear Fluid Imbalance

Symptoms are typically related to dysfunction of the balance (vestibular) and hearing (cochlear) systems:
 

1. Vertigo and dizziness
   Sudden spinning sensation (true vertigo) that may last from minutes to several hours, often accompanied by unsteadiness or difficulty walking.
    

2. Tinnitus
   Ringing, buzzing, roaring, or other noises in the affected ear, especially noticeable in quiet environments.
    

3. Fluctuating or reduced hearing
   Hearing loss in one or both ears; in some cases, hearing may temporarily improve between attacks.
    

4. Aural fullness
   A feeling of pressure or “blocked” sensation in the ear.
    

5. Nausea and vomiting
   Severe vertigo episodes can cause significant nausea and vomiting.
    

Diagnosis

Diagnosis requires comprehensive evaluation by an ENT specialist. Common diagnostic methods include:
 

1. Detailed history and symptom review
   Discussing onset, frequency, triggers, past trauma, infections, or family history.
    

2. Hearing tests
   Pure-tone audiometry, speech testing, and tympanometry to assess hearing function.
    

3. Inner ear function tests

   • Videonystagmography/Electronystagmography (VNG/ENG): Evaluates vestibular (balance) system function.

   • Otoacoustic Emissions (OAE): Checks health of inner ear hair cells.
      

4. Imaging studies

   • MRI: To rule out structural issues such as acoustic neuroma.

   • CT scan: To examine bony structures of the inner ear.
      

5. Electrocochleography (ECoG)
   Measures inner ear fluid pressure; particularly useful for confirming Ménière’s disease.
    

Treatment Options

Treatment aims to control symptoms, reduce attack frequency, and improve quality of life:
 

1. Medications

   • Diuretics: Reduce endolymph accumulation and lower inner ear pressure.

   • Anti-vertigo drugs (e.g., Betahistine): Improve inner ear blood flow and relieve vertigo/tinnitus.

   • Anti-nausea medications: Control vomiting during attacks.

   • Steroids: Treat inflammation or autoimmune-related cases.
      

2. Lifestyle modifications

   • Low-salt diet: Helps reduce fluid retention and inner ear pressure.

   • Avoid triggers: Caffeine, alcohol, nicotine, and stress.

   • Stress management: Exercise, meditation, or counselling.
      

3. Vestibular rehabilitation therapy
   Guided exercises by a physiotherapist to retrain the balance system and reduce dizziness.
    

4. Surgical treatment (for severe, refractory cases)

   • Endolymphatic sac decompression/shunt

   • Vestibular nerve section or labyrinthectomy

   • Semicircular canal occlusion
      

5. Other treatments

   • Positive pressure therapy (e.g., Meniett device) to reduce inner ear pressure.

   • Hearing aids for patients with permanent hearing loss.
      

The ENT specialist team at Honser Medical Centre, equipped with advanced diagnostic tools and extensive clinical experience, provides comprehensive evaluation and treatment for patients with ear fluid imbalance. Our services include:
 

• Hearing tests and vestibular function assessments

• Personalised medication and rehabilitation programmes

• Surgical treatment and post-operative care
   

For more information or to book an appointment, please call or contact us via WhatsApp.