Perilymphatic fistula

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By Paul Foster MD
Jungmin Ahn, Se-Eun Son, Ji Eun Choi, Young Sang Cho, Won-Ho Chung
OBJECTIVE: To analyze surgical results on hearing and vestibular symptoms in patients with barotraumatic perilymphatic fistula (PLF) according to diagnostic criteria. METHODS: A total of 39 patients (41 ears) who underwent surgery on suspicion of barotraumatic PLF from January 2005 to December 2017 were included. Pure tone audiometry and videonystagmography (VNG) recording for spontaneous nystagmus and positional tests were performed preoperatively and postoperatively at 1 week and 1 month...
February 15, 2019: Otology & Neurotology
Jonathan R Mallen, Daniel S Roberts
OBJECTIVES: Challenge current practices and misconceptions in treating recreational SCUBA (Self-contained underwater breathing apparatus) divers. Differentiate patients who are fit to dive and those with relative and absolute contraindications. Redefine the standard of care for fitness to dive parameters based on the most up-to-date evidence. METHODS: We conducted a review of the available medical and diving literature in English, German, Spanish, Italian, Turkish, and French to determine the degree of evidence or lack thereof behind recommendations for treating SCUBA divers...
January 2020: Laryngoscope
Jonathan R Mallen, Daniel S Roberts
OBJECTIVES: Introduce pertinent self-contained underwater breathing apparatus (SCUBA) physiology and corresponding terminology. Appreciate the scope of diving and related otolaryngological injury. Illustrate pathophysiologic mechanisms for diving injuries. Summarize strategies for ear, paranasal sinus, and lung barotrauma prevention, including medical optimization and autoinsufflation techniques. METHODS: We conducted a review of the available medical and diving literature in English, German, Spanish, Italian Turkish, and French to determine the degree of evidence or lack thereof behind recommendations for treating SCUBA divers...
January 2020: Laryngoscope
N K Prenzler, B Schwab, D M Kaplan, S El-Saied
PURPOSE: The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome. STUDY DESIGN: Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005. SETTINGS: Tertiary care university-affiliated hospital...
January 2018: American Journal of Otolaryngology
P K Foster
OBJECTIVE: To assess an alternative to bed rest and surgery for suspected perilymphatic fistulas using intratympanic blood injections. METHOD: A review was conducted of patients' history, physical and audiometric data, before and after treatment by intratympanic blood injections performed from 2009 to 2015. RESULTS: Twelve ears were identified, with trauma associated with air travel, water sports or nose blowing. Ten of these cases had hearing loss, six had vestibular symptoms...
December 2016: Journal of Laryngology and Otology
Ji Eun Choi, Il Joon Moon, Hankyeol Kim, Kieun Lee, Yang-Sun Cho, Won-Ho Chung
CONCLUSIONS: Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF. OBJECTIVES: The aim of this study was to establish diagnostic criteria for barotraumatic PLF. METHODS: Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF...
January 2017: Acta Oto-laryngologica
Richard K Gurgel, Robert K Jackler, Robert A Dobie, Gerald R Popelka
The lack of an adequate standardized method for reporting level of hearing function in clinical trials has hampered the ability of investigators to draw comparisons across studies. Variability in data reported and presentation format inhibits meta-analysis and makes it impossible to accumulate the large patient cohorts needed for statistically significant inference. Recognizing its importance to the field and after a widely inclusive discussion, the Hearing Committee of the American Academy of Otolaryngology-Head and Neck Surgery endorsed a new minimal standard for reporting hearing results in clinical trials, consisting of a scattergram relating average pure-tone threshold to word recognition score...
November 2012: Otolaryngology—Head and Neck Surgery
Brian Kung, Robert T Sataloff
Perilymph fistulae are difficult to diagnose because they present with a wide variety of signs and symptoms, they are associated with many etiologies, and they often mimic other conditions. In this article, we describe a case of perilymph fistula that featured one of its more rare causes: acoustic trauma--specifically, damage from a loud blast from the siren of a fire engine. We also review the literature and discuss the difficulties of diagnosis and treatment and the possible mechanisms by which acoustic trauma and other etiologies cause perilymph fistulae...
April 2006: Ear, Nose, & Throat Journal
S Scott Lollis, Dudley J Weider, Joseph M Phillips, David W Roberts
OBJECT: The goal of this study was to provide preliminary data regarding clinical and functional outcome, including postoperative morbidity, related to ventriculoperitoneal (VP) shunt insertion for refractory perilymphatic fistula. METHODS: The authors retrospectively reviewed the records of seven consecutive patients who had undergone VP shunt insertion for medically and surgically refractory perilymphatic fistula between 1996 and 2004. Patients were also contacted by telephone and asked to assess retrospectively their symptomatic improvement, changes in functional status, and changes in work status following shunt placement...
July 2006: Journal of Neurosurgery
R J Sim, A H Jardine, E J Beckenham
UNLABELLED: A number of authors have suggested that surgery for suspected perilymph fistula is effective in preventing deterioration of hearing and in improving hearing in some cases in the short term. We present long-term hearing outcome data from 35 children who underwent exploration for presumed perilymph fistula at The Children's Hospital, Sydney, Australia, between 1985 and 1992. METHODS: The pre-operative audiological data (mean of 500, 1000, 2000 and 4000 Hz results) were compared with the most recently available data (range two to 15 years) and the six-month post-operative data...
March 2009: Journal of Laryngology and Otology
Ga Young Park, Hayoung Byun, Il Joon Moon, Sung Hwa Hong, Yang-Sun Cho, Won-Ho Chung
OBJECTIVES: Treatment of traumatic perilymph fistula (PLF) remains controversial between surgical repair and conservative therapy. The aim of this study is to analyze the outcomes of early surgical exploration in suspected barotraumatic PLF. METHODS: Nine patients (10 cases) who developed sudden sensorineural hearing loss and dizziness following barotrauma and underwent surgical exploration with the clinical impression of PLF were enrolled. Types of antecedent trauma, operative findings, control of dizziness after surgery, postoperative hearing outcomes, and relations to the time interval between traumatic event and surgery were assessed retrospectively...
June 2012: Clinical and Experimental Otorhinolaryngology
Jeremy Hornibrook
Perilymph fistula (PLF) is defined as a leak of perilymph at the oval or round window. It excludes other conditions with "fistula" tests due to a dehiscent semi circular canal from cholesteatoma and the superior canal dehiscence syndrome. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural tissue became routine. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF...
2012: ISRN Otolaryngology
Jeremy Hornibrook
Perilymph fistula is defined as a leak of perilymph at the oval or round window. It excludes other conditions with "fistula" tests due to a dehiscent semicircular canal from cholesteotoma and the superior canal dehiscence syndrome. First recognized as a complication of stapedectomy, it then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause. Descriptions of "spontanenous" perilymph fistulas with no trauma history followed. It is likely that most perilymph fistula patients have a congential potential weakness of the otic capsule at the round or oval window...
2012: International Journal of Otolaryngology
Alexander J Saxby, Marcela Fandino, Frederick K Kozak
No abstract text is available yet for this article.
January 2018: ANZ Journal of Surgery
Ektor Tsuneo Onishi, Yotaka Fukuda
UNLABELLED: Perilymphatic fistulas still represent a major treatment challenge. In some cases, its surgical closure can reduce auditory and vestibular sequelae. AIM: To compare the behavior of cochlear window perilymphatic fistulas in guinea pigs as to their natural evolution and immediate surgical closure. MATERIALS AND METHODS: Experimental study. Forty guinea pigs were submitted to cochlear window membrane lesion and randomly broken down into two groups: open fistula (OF) and surgically closed fistula (SCF)...
March 2010: Brazilian Journal of Otorhinolaryngology
M Al Felasi, G Pierre, M Mondain, A Uziel, F Venail
OBJECTIVE: To highlight diagnostic and treatment pitfalls in perilymphatic fistula. CASE REPORTS: Two cases of round-window fistula are reported, detailing clinical aspect, treatment and outcome. The triad comprising sensorineural hearing loss, tinnitus and vertigo with associated fistula sign is classical but in fact rarely encountered. Imaging is of limited contribution, but may reveal anatomic abnormalities suggestive of perilymphatic fistula. Outcome is improved by early management, especially in case of moderate hearing loss...
June 2011: European Annals of Otorhinolaryngology, Head and Neck Diseases
Nitin Bhatia, Joel F Lehrer
Perilymphatic Fistula (PLF) remains a controversial topic and its management is challenging. Various etiologic events have been proposed and spontaneous PLF has been described 1. Diagnostic methods and strategies have been reported in the literature but no standard algorithm exists. The most accepted diagnostic method remains intra-operative confirmation of perilymph leak at oval window or round window. However, concerns have been raised regarding excessive surgical intervention given the lack of pre-operative confirmatory tests...
2012: International Tinnitus Journal
Anamaria Gocea, Brigida Martinez-Vidal, Charlotte Panuschka, Pilar Epprecht, Miguel Caballero, Manuel Bernal-Sprekelsen
The management of labyrinthine fistula is a controversial issue. Hearing preservation represents a major challenge. Retrospective study of 31 patients with labyrinthine fistula confirmed intra-operatively during cholesteatoma surgery. In all cases, total matrix removal was performed, and the fistula covered with bone dust, periostium and/or cartilage. Twenty-five patients received a high intra-operative dosage (500 mg) of intravenously applied steroids at least 15 min before handling the fistula. Outcome measurements included comparison of the pre-operative and post-operative bone conduction to assess inner ear function...
April 2012: European Archives of Oto-rhino-laryngology
Ilmari Pyykkö, Ziane Selmani, Jing Zou
This study was designed to verify an eventual perilymphatic fistula (PLF) in 264 patients with sensorineural hearing loss (SNHL) and/or vertigo. The patients were exposed to a low-frequency sound stimulation (LFS) on posturography to objectively test Tullio's phenomenon and Hennebert's sign. Endoscopes with 5 degree and 25 degree of visual angle and an outer diameter of 1.7 mm were used. The round window niche, with its foldings, oval window with stapes superstructure, a part of the facial recess and the area in the fissula ante fenestram were examined and video recorded...
2012: ISRN Otolaryngology
Frank Haubner, Christian Rohrmeier, Christoph Koch, Veronika Vielsmeier, Jürgen Strutz, Tobias Kleinjung
UNLABELLED: <AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Aim of the present study was to evaluate the occurence of a round window membrane rupture and the effects of hearing restoration after exploratory tympanotomy and sealing of the round window (niche) in patients with unilateral sudden deafness. METHODS: Retrospective analysis of patients' charts in a tertiary referral center. Charts of 69 patients with sudden deafness followed by exploratory tympanotomy were retrospectively analyzed...
November 29, 2012: BMC Ear, Nose, and Throat Disorders
2015-11-24 16:05:51
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