That PLF patients may have a unique balance problem was first suggested by Singleton [ 82 ]. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF. Diagnosis of perilymph fistula using ENG and impedance. In that regard a change on the intraoperative EcochG [ 71 — 73 ] is the most unequivocal test that a window fistula is present, but it requires special equipment and is unavailable to most. Barany believed these observations were explained by hypermobility of the stapes.

This paper reports an 8-year experience with patients whose symptoms were compatible with Meniere’s disease but who had some other element that raised the possibility of their having a PLF. Please review our privacy policy. In animal models of PLF some animals show histological evidence of hydrops, but this is not proof that hydrops is the cause of the predominant vestibular symptoms in humans. In the patients no fistula was seen. The etiology is either congenital or acquired.

InHennebert [ 4 ] described nystagmus induced by alternating positive and negative pressure in the ear canal in syphilitic patients.

Perilymph Fistula: Fifty Years of Controversy

Six testing protocols were compared. Perilymphatic fistula with no visible leak of fluid into the middle ear: At the age of fjstula, after being next to a five inch firing gun, his hearing in the right ear and balance became worse and sneezing would make him stagger. A trauma history was elicited in nearly all. Perilymph fistulas in infants and children.

Perilymphatic fistula and Meniere’s disease. Clinical series and literature review.

The aim of this review of the literature is to define the guidelines for preoperative diagnosis to indicate exploratory tympanotomy both in children and in adults.


High resolution computed tomography of isolated anomalies of the stapes: Early temporal studies in the s [ 26 ] showed perilmyph a crack between the round window niche and the ampulla of the posterior canal was not uncommon, but it was assumed to be an artefact.

Fluorescein use in the detection of perilymphatic fistula: Only ten had a definite congenital abnormality. Suggestions for progress are offered. At the oval window a fistula is nearly always at its anterior edge, that is, at the fissula ante fenestram. In Goodlhill’s paper [ 22 ] on sudden sensorineural deafness diagnosed as having PLF two were children with a history pwrilymph exertion. Ruttin [ 5 ] showed that Hennebert’s sign was sometimes associated with a destructive lesion of the labyrinthine capsule by cholesteatoma.


literature review perilymph fistula

There are already excellent large reviews on the topic [ 1 — 3 ]. Otolaryngologic Clinics of North America.

Congenital and acquired perilymph fistula: review of the literature.

The resolution of temporal bone imaging by computed tomography CT and by magnetic resonance imaging MRI is improving. Vestibular hypersensitivity to clicks is characteristic of the Tullio phenomenon.

Diagnosis and treatment of perilymph fistulas without hearing loss. Barany believed these observations were explained by hypermobility of the stapes. After an inner ear injury, there is nearly always recovery or central adaption. The most common symptoms of a PLF are vestibular, but a confusing range of unverified terms has been used and needs to be clarified.


American Journal of Otology. International Journal of Pediatric Otorhinolaryngology.

literature review perilymph fistula

The patient died four years later and his temporal bones were obtained for histology. Gibson [ 71 ], a pioneer of electrocochleography, used intraoperative tone stimulus EcochG during stapedectomy and cochleostomy surgery with a silver ball electrode placed on the round window or litreature window.

Comparison of endoscopic and surgical explorations for perilymphatic fistulas. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural revieq became routine. Kung B, Sataloff RT. There is an almost total absence of detailed cases of postmortem histology on ears with a premortem diagnosis of a treated PLF. Validity of spontaneous perilymphatic fistula.

Perilymph Fistula: Fifty Years of Controversy

Sudden deafness and labyrinthine window ruptures. All the PLF patients showed altered postural stability, but not the controls with a pure sensorineural hearing loss.

Trauma from head injury, flying and diving barotrauma, sneezing, coughing, and labor as the most common cause of a PLF has been a peerilymph in all the institutional series discussed.

InTonkin and Fagan [ 24 ] reported on thirteen patients with a round window fistula where the initiating event appeared to be direct head trauma in four, but exertion, barotrauma from flying and diving, acoustic trauma, vomiting, and postoperative in the remainder.

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