{"id":320,"date":"2021-01-04T15:21:09","date_gmt":"2021-01-04T22:21:09","guid":{"rendered":"https:\/\/neurotucson.fm1.dev\/ear-hearing\/perilymph-fistula\/"},"modified":"2021-02-02T17:41:59","modified_gmt":"2021-02-03T00:41:59","slug":"perilymph-fistula","status":"publish","type":"page","link":"https:\/\/neurotucson.com\/ear-hearing\/otology\/perilymph-fistula\/","title":{"rendered":"Perilymph Fistula"},"content":{"rendered":"\n

A perilymph fistula (PLF) is an abnormal communication between the middle and inner ears, typically resulting from tears in the oval or round windows. When there is an abnormal opening, perilymph (fluid found within the inner ear) leaks into the middle ear space. PLFs are most commonly caused by head trauma; however, other etiologies include barotrauma, congenital PLF (present at birth),\u00a0cholesteatoma<\/a>-related bone erosion, and prior ear surgery. Symptoms of PLF include: chronic imbalance along with episodes of true vertigo (a feeling of spinning when you are not moving) caused by bending\/straining, nausea, vomiting, progressive hearing loss, non-pulsatile tinnitus, and a feeling of fullness in the affected ear. In some cases, Tullio\u2019s phenomenon (sound-induced vertigo) may also be experienced.<\/p>\n\n\n\n

Diagnosis of a PLF can be challenging, especially when there is no history of ear barotrauma. This is because the symptoms are non-specific, similar to other inner ear conditions such as Meniere\u2019s disease (insert link). Workup includes audiometric (hearing) testing, balance testing, and fistula tests that record eye movements in response to changes in ear canal pressure or sound levels. A CT or MRI scan may also be indicated. Often the diagnosis is confirmed only by surgical exploration of the middle ear.<\/p>\n\n\n\n

Bed rest is often recommended to allow the fistula time to heal on its own. Activities that are discouraged include: air travel, lifting\/straining, blowing the nose, bending over, and any other activities that may cause changes in pressure within the inner ear. Medications may be prescribed to reduce symptoms of nausea and vomiting. For PLFs that fail to heal on their own (especially those causing progressive sensorineural hearing loss or vertigo), surgical repair with use of tissue grafts to close the hole is recommended.<\/p>\n\n\n\n

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