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Structure and function of the cochlear aqueduct.

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J LEMPERT, P E MELTZER, E G WEVER, M LAWRENCE, J H T RAMBO. 1952. Structure and function of the cochlear aqueduct.. https://doi.org/10.1001/archotol.1952.00710010143003

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[Validation of a clinical scale for the diagnosis of perilymphatic fistula].

INTRODUCTION: The diagnosis of perilymphatic fistula (PLF) is difficult because no single clinical situation gives the diagnosis for sure. The goal of this article is to study the clinical situations where you must suspect a PLF and to support a clinical scale described in a previous work (Bussières et al 2003). METHODS: Retrospective study of 15 patients that had an exploratory tympanotomy with a PLF not confirmed preoperatively. An analysis of the symptoms, signs and complementary exams were done. The surgical technique and findings and the postoperative evolution were noted. RESULTS: There is 66.7% of hypoacusis the most frequently symptom (postoperative improvement of 26.7%); after came vertigo present in 60% (postoperative improvement of 44.4%) and tinnitus present in 53.3% (postoperative improvement of 25%). The trauma history is always positive, most of then is typical (80%) and the other one are atypical (20%).The diagnosis of PLF has been determined in 5 patients in the follow-up according to the improvement of the symptoms. These patients had a score > 7 at the clinical scale. CONCLUSION: The sensibility and specificity scores of the clinical scale are respectively 100% and 70% in this study.

Cochlear Aqueduct↗

Perilymphatic fistula.

A perilymph fistula is an abnormal connection between the inner and middle ear that allows escape of perilymph fluid into the middle ear compartment. The clinical symptomatology that follows leakage of fluid is by and large indistinguishable from a number of other pathologies that affect inner ear function. Definite diagnostic proof of a perilymph fistula remains elusive, and methods of diagnosis remain controversial. Traumatic tears in the oval or round windows remain a major cause of perilymph fistula, yet an index of suspicion in traumatic brain injury frequently remains low. The diagnosis of perilymph fistula must always be considered in the appropriate clinical setting of head trauma, barotrauma, and in patients with unresolved and undiagnosed episodes of recurrent vertigo or hearing loss. Surgical treatment with patching of oval and round windows remains the mainstay of therapy for this condition.

Cochlear Aqueduct↗