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Hydrops Layer with Communicating
Hydrocephal- about a Case
Ligia Acosta Boett*1 and Teolinda Morales2
1Pediatrician Otorhinolaryngologist, Department of Otoneurology, Institute of Otorhinolaryngology, Venezuela
2Medical Otorrinolaringólogo, Department of Otoneurology, Institute of Otorhinolaryngology, Venezuela
Submission: February 27, 2017; Published: March 09, 2017
*Corresponding author: Acosta Boett Ligia, Jefe de Servicio de Otorrinolaringología. Hospital de Niños “Dr. José Manuel de los Ríos”, icepresidenta de la Junta Directiva SVORL, Venezuela, South America, Email:firstname.lastname@example.org
How to cite this article: Ligia A B, Teolinda M. Hydrops Layer with Communicating Hydrocephal- about a Case. Glob J Oto 2017; 5(1): 555652. DOI: 10.19080/GJO.2017.05.555652
The Labyrinthine Hydrops is defined as the dilatation of the labyrinthine membranes associated with an increase of the endolaberinticos liquids, manifested by Vertigo, Tinnitus, Fullness Otica and Hearing Loss. Its etiology is unknown; However, endolymphatic duct obstruction and labyrinthine microhomostasis disorders have been considered responsible pathogenic factors. We present the case of a 28-year-old female patient with rotational, positional, seizure-like dizziness, with a 3-month course of concomitant nausea, bilateral tinnitus and constant headache. Integral Otoneurological study is performed which reveals: Bilateral labyrinthine irritability and Cerebral RSM with communicating global hydrocephalus. Peritoneal Ventricle Derivation is performed with resolution of Hydrocephalus and disappearance of the Vestibular Cocleo symptomatology.
It is evaluated jointly with Neurosurgery, suggesting
Peritoneal Ventricle Derivation, it is intervened surgically
obtaining a satisfactory resolution of hydrocephalus with
disappearance of the cochleovestibular symptomatology.
Currently 3 years postoperative, in control and follow-up,
Labyrinthine Hydrops is defined as the dilatation of
labyrinthine membranes associated with an increase in
endolaberinic fluid, clinically manifested by Vertigo, Tinnitus,
Optical Plenitude, and can reach Hearing Loss. Its etiology is
unknown. An origin has been postulated:
Embryopathic (Dysplasia of Mondini), Acquired (post
infections, trauma, metabolic, endocrine, immunological,
vascular disorders), Ideopathic (Meniere’s disease). Mechanical
obstruction of the endolymphatic duct and labyrinthine
microhomostasis disorders have been considered as pathogenic
factors responsible for Labyrinthine Hydrops [1-3]. The constant
and balanced composition of the fluids of the inner ear are
fundamental for the good functioning of the vestibular cochlea.
Provide an appropriate and specific ionic environment
for optimal generation of biopotentials necessary for proper
inner ear function.
Keep the internal ear pressure balanced; The
hydrostatic CSF variations are transmitted by the cochlear
aqueduct to the perilymphatic spaces, simultaneously
this pressure of the liquid is exerted on the walls of the
endolymphatic sac, which causes the pressures to be equal
on both sides of the Reissner membrane.
They allow the transportation of nutrient principles to
the terminal organs and the elimination of metabolic waste
products from the cochlea.
Medium of transmission of the vibrations that go from
the stirrup to the energy transforming centers of the middle
Fluids from the inner ear are in contact with the surrounding
tissues, they communicate directly or indirectly with the
CSF and / or blood, with a permanent exchange of ions and
metabolites, due to the biochemical differences between them
[1,4]. Intracranial pressure may modify the intralaberintic
pressure directly by the Cochlear Aqueduct or indirectly by the
labyrinthine branches of the intracranial vasculature, especially
the microvenules [5,6]. The maintenance of microhomostasis of
internal ear fluids depends on:
Energy-dependent ion pumps.
Constant blood circulation
There are several situations, conditions, or factors that
may disturb maintenance of microhomostasis of endolaberinic
fluids, leading to accumulation of ions, metabolites, excess fluid
in the inner ear compartments, leading to osmotic imbalance,
labyrinthine membrane distention And consequently functional
disturbances of balance and hearing [1,7,8]. In the case described
above, Global Communicating Hydrocephalus is considered to
be the disturbing condition of microhomostasis of endolaberinic
fluids, conditioning osmotic imbalance, labyrinthine membrane
distention and Labyrinthine Hydrops.
In the discussion with Neurosurgery, it is suggested that the
mild Stenosis of the Silvio Aqueduct (congenital malformation),
until now had been adequately tolerated by the patient, since
it allowed good management of cerebral fluid dynamics with
adequate CSF flow and drainage, is unknown The cause of
increased intracranial water volume (no positive history in the
annanesis), responsible for communicating global hydrocephalus,
because there is only limitation in the flow and drainage of the
CSF, but no obstruction (Obstructive Hydrocephalus). It could
be considered viral or immunological post-infectious etiology
that caused fibrosis or adhesions of the arachnoid villi in the
sagittal sinus, with limitation in the reabsorption of the CSF.
Therefore, taking into account the relationship between CSF
and endolaberinic fluids, we consider Hydrocephalus as a causal
factor of Labyrinthic Hydrops, in our case, when hydrocephalus
was resolved, recovery of microhomostasis was achieved,
evidently with the disappearance of the Cocleovestibular
symptomatology, therefore we conclude:
Endolaberinic fluids directly and indirectly contact the
Hydrocephalus is a disorder of cerebral fluid dynamics
that can disturb the microhomostasis of the fluids of the
inner ear, conditioning a labyrinthine Hydrops.
The RSM Cerebral is a complementary examination in
the pathogenesis of the Labyrinthic Hydrops.