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perilymph fistula
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- anatomy
- the inner ear which is encased in bone is seperated from the middle ear at two thin membranous locations called the oval and round windows (1)
- rupture of the oval or round window results in leakage of perilymph into the middle ear
- this is termed a perilymphatic fistula
- causes:
- usual cause is a sudden change in atmospheric pressure due to
- flying
- diving (otitic barotrauma)
- sudden physical exertion
- excessive straining(e.g.childbirth)
- stapedectomy
- usual cause is a sudden change in atmospheric pressure due to
- clinical features
incude
- sudden or fluctuating hearing loss (1)
- vertigo
- lightheadedness
- disequilibrium
- motion intolerance
- nystagmus
- investigations and diagnosis
- the following tests help in the diagnosis
(1)
- audiogram
- tympanogram
- electronystagmography (ENG)
- electrocochleography (ECoG)
- CT scan of the temporal bone
- the fistula test is positive
- the following tests help in the diagnosis
(1)
- treatment
- bedrest
- urgent referral to an otologist
- definitive treatment is surgical
- procedure
- takes about 30 minutes
- the ear drum is lifted up through the ear canal and the round and oval windows are patched
- procedure
Reference:
Last reviewed 01/2018
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