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2698 pages added, reviewed or updated during the last month (last updated: 12/4/2021)


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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
  • 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
  • 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

Reference:

(1)diving-related diseases of the ear, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine© 2006 The Regents of the University of California

Last reviewed 01/2018

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