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Endolymph is a fluid found within the membranous labyrinth of the inner ear. It is unique among extracellular fluids due to its high concentration of potassium ions and low concentration of sodium ions. This ionic composition differs significantly from perilymph, another fluid in the inner ear, and from other bodily extracellular fluids.1

The formation and maintenance of endolymph are not fully understood, but it is believed to be produced from perilymph through selective ion transport across the Reissner membrane. The stria vascularis, located in the cochlear duct, plays a crucial role in maintaining the high potassium-to-sodium ratio in the endolymph.1

Endolymph is essential for the function of the semicircular canals, which are responsible for sensing head rotation and maintaining balance. Movement of the head causes the endolymph to displace a jelly-like structure called the cupula, which in turn stimulates hair cells. This process generates neural impulses sent to the brain, enabling coordinated movement and visual stability. Abnormal buildup of endolymph can lead to conditions like Meniere disease, causing symptoms such as hearing loss and vertigo.2

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