Pathophysiology of Hydrops endolymphatic


Pressure considerations

Both acute endolymphatic hydrops and the early phase (up to 5 weeks) of chronic
hydrops generally occur with negligible (5 weeks after sac ablation), one study found no endolymph pressure
increase in 33% of the animals and a mean increase of less than 1 mm Hg, and
another found no significant elevation at all, with a mean increase of 0.003 mm
Hg. These findings in the ear contrast with measurements of ocular pressure, which
vary from 10 to 21 mm Hg in the normal eye and are typically greater than 22 mm Hg in
patients with open-angle glaucoma. In terms of the dependence of pathology on pressure,
it is apparent that endolymphatic hydrops and glaucoma of the eye are
completely different and that the role pressure plays in endolymphatic hydrops is, at
best, limited.
A recent study has shown that the endolymphatic sac may play some part in endolymph
pressure regulation. Systemic isoproterenol (b-adrenergic agonist) increased
endolymph pressure and decreased the potential of the endolymphatic sac lumen,
while not affecting CSF pressure. This action was suppressed in animals in which
the endolymphatic sac was surgically ablated, implicating the sac as the source of the
changes.

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