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PubMedDate not supplied

Tympanic membrane displacement analyser tracing modifications induced by glycerol in Menière's disease.

The aim of the study was to detect inner ear fluid pressure changes induced by glycerol in Menière's disease (MD) by means of a tympanic membrane displacement analyser (TDA). The study group consisted of 25 MD patients. The Vi (maximum inward displacement of the tympanic membrane) and the Vm (mean displacement of the tympanic membrane) were measured at 10, 20 and 25 dB above the stapedial reflex threshold. Each patient received therapy based on glycerol. The control group consisted of 20 patients with non-hydropic sudden hearing loss. At 20 and 25 dB above stapedial threshold MD patients had lower Vi values before therapy. After glycerol, we observed a Vi increasing in the hydropic ears in 68-96 per cent of patients. Since a Vi improvement implies a reduction of perilymph pressure, our results confirm the effectiveness of Vi in detecting specific action of glycerol in MD.

Adolescent↗
PubMed2001

[Etiology of labyrinthine perilymphatic fistula].

The examination of 120 patients with verified labyrinthine fistulas (LFs) has demonstrated that perilymphatic LFs most often are caused by rupture of the cochlear window's membrane (54%). Among other reasons were broken base of the stapes (6%), the defect in the area of both windows (17%), rupture of the annular ligament of the stapes (15%), defects in the area of semicircular canals. Incompetence of the stapedial piston prosthesis is documented.

Adult↗
PubMedDate not supplied

[Perilymphatic fistula: report of a case which resolved spontaneously in five days and literature review].

AIMS: We report a patient with a perilymphatic fistula and review the literature on this topic. CASE REPORT: The patient was a 50 years old male with a five days history of intense and continuous vertigo associated with nausea, vomiting and sweating, which was initiated after a sudden noise in the left ear. The symptoms resolved spontaneously over five days, without surgical treatment. The clinical picture resembles those previously reported for perilymphatic fistula. The current literature on this topic has been reviewed in this article. CONCLUSION: The patient presented an early recovery, what corroborates the current tendency of waiting a few weeks before indicating surgery.

Cochlear Aqueduct↗
PubMed2002

Perilymphatic fistula following trans-tympanic trauma: a clinical case presentation and review of the literature.

The perilymphatic fistula is constituted by an anomalous connection between the perilymphatic space and the middle ear. The principal accuses are to be sought in the intracranial pressure increasement, cranial traumas, barotraumas, congenital anomalies, trans-tympanic traumas, etc. Stapes's dislocation in the vestibule and the fracture of the platina are the most frequent pathogenic mechanisms. In clinical practice, the diagnosis remains a problem rather debated, even if the clinical pattern, the laboratory investigations, the diagnostic images and the tympanic exploration, all together can confirm, in the majority of the cases, the diagnostic suspect. This article presents a clinical case of a transtympanic trauma with perilymphatic fistula caused by a foreign body. The peculiarity of this case must be set in relation with both the aetiopathogenesis of the labyrinthine lesion and the severity of the symptomatology caused by it.

Anti-Inflammatory Agents↗
PubMed2003

[When to suspect a perilymphatic fistula?].

INTRODUCTION: The diagnosis of perilymphatic fistula (PLF) is difficult since no single clinical situation gives the diagnosis for sure. The goal of this study is to clarify the clinical situations where you must suspect a PLF. METHODS: Retrospective study of 20 patients that had an exploratory tympanotomy with a PLF confirmed peroperatively. An analysis of the symptoms, signs and complementary exams was done. The surgical findings and the postoperative evolution were noted. RESULTS: 100% of patients reported a hearing loss, 80% vertigo, 70% a tinnitus and 35% equilibrium problems. Every patient had an etiological event to explain the PLF (trauma 85%), stapedotomy (10%), other ear surgeries. Five patients had a positive fistula or Vasalva test. All patients except one had an hearing loss on the audiogram (sensorineural, mixte or conductive). 50% had a CT scan, 70% of which were abnormal. A VNG was done on 3 patients. The sites of the PLF were as follows: 90% oval window, 5% round window and 5% both windows. The hearing got better or was stabilised in 95% of patients after the operation. 64% saw an improvement of their tinnitus and 87% of their vertigo. CONCLUSION: The diagnosis of PLF is difficult and a high index of suspicion is mandatory. One must look for an etiologic situation to explain the PLF. The audiogram is almost always modified, a mixte hearing loss being common due to the high incidence of ossicular trauma associated with PLF. The clinical clinical situations where you must suspect a PLF were identified as follows: An old trauma, a recent trauma, a history of otologic surgery particularly on the stapes and a preexisting hearing loss that aggravates. A diagnosis scale to evaluate the risk of PLF, based on clinical situations, physical exam and complementary exams was done to help the clinician in the evaluation of PLF.

Adolescent↗
PubMed2005

Perilymphatic fistula in cabin attendants: an incapacitating consequence of flying with common cold.

A perilymphatic fistula (PLF) is an abnormal communication between the inner ear and the middle ear that leaks perilymph. PLF is considered rare, but is known to occur during childbirth, straining, weightlifting, head trauma, and diving with middle ear equalizing problems. It has also, anecdotally, been described in connection with flying. The symptoms are uncharacteristic vertigo and, in some cases, hearing impairment and tinnitus. This study describes four cases of PLF during a period of 6 mo in a major Scandinavian airline company employing approximately 3000 cabin attendants (CAs). None of the cases were diagnosed at the primary health care level. All were referred to the Aviation Medical Center for investigation. The PLF diagnosis was based on the case history, Platform Pressure Test (a fistula test), and other vestibular tests. Only one CA has been able to return to flying duties. The article emphasizes the risk of flying with poor middle ear equalization and the necessity of reminding crews and airline companies to "never fly with a common cold".

Adult↗
PubMed2005

[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↗
PubMed1990

Recurrent meningitis secondary to perilymph fistula in young children.

All young children treated for meningitis should have post-treatment evoked potential audiometry. If neurosensory hearing loss is identified, the clinician should be alerted to the possibility of a perilymph fistula as the cause of the meningitis. Radiology of the inner ear and possibly exploratory tympanotomy may be necessary to rule out a perilymph fistula. Two young children with meningitis secondary to perilymph fistula are presented to illustrate the problems of diagnosis and management.

Audiometry, Evoked Response↗
PubMed1988

Perilymphatic fistula: a New Hampshire experience.

Thirty-five patients with perilymphatic fistulas (PLFs) are presented. Of this group of 35 patients (39 ears), 4 patients did not have fistulas that could be observed with certainty but were presumed to have fistulas by virtue of their excellent response to surgical repair. Our case reports provide examples of the great variety and possible classifications of presentations and symptom complexes that lead one to suspect the diagnosis of perilymphatic fistula. Comments on diagnostic and therapeutic modalities and on postoperative care and counseling are included. The age range of patients in our series is 3 to 67 years. Four patients are under age 20, and an additional three patients probably developed their symptoms prior to age 20 but presented later. Twenty-three (79%) of 29 patients with spontaneous PLFs began having symptoms closely related to some event involving physical or mechanical stress, and a high percentage (76%) had symptoms aggravated by physical stress. Six are believed to have fistulas of congenital origin. There is a sibling pair and a mother and son in the series; these four people had bilateral fistulas.

Adolescent↗
PubMed1988

Surgery of the round window.

Tympanotomy is routinely performed in our institution to control the round window membrane for patients with recurrent sudden deafness, with Meniere-like attacks, and those with Meniere's disease. In a large number of these patients, especially those with vertigo, perilymph fistula has been diagnosed. Most patients are free of attacks after the fistula has been closed, and in those with a short history of illness, hearing can become normal. In the future, closure of the round window membrane should be considered an important procedure in the treatment of inner ear dysfunctions.

Barotrauma↗
PubMed1987

Pneumolabyrinth in perilymphatic fistula: report of three cases.

In three patients with perilymphatic fistula, exploratory tympanotomy revealed air bubbles emerging through the ruptured round window membrane. Review of the literature disclosed three case reports in which air was demonstrated in the labyrinth in association with perilymphatic fistula. Experimental evidence that air could enter the labyrinth through a defect of the round window membrane was described in two articles. In our patients, the perilymphatic fistula was produced by implosive force. When a perilymphatic fistula was produced by implosive force, or in the case of a pre-existing perilymphatic fistula, we assume, air may enter the scala tympani through the defect of the round window membrane if the middle ear pressure rises beyond a certain limit. Sudden onset of deafness and reversibility of hearing in perilymphatic fistula could be attributable to the presence of air bubble in the scala tympani--pneumolabyrinth--which might disturb propagation of the traveling wave of the basilar membrane.

Adolescent↗