Perilymph fistula

Perilymph fistula is a tear or defect in the bony capsule of the labyrinth or in the round or oval windows, the thin membrane separating the middle ear from the fluid filled inner ear. If there is a fistula the pressure in the middle ear changes which would directly affect the inner ear affecting the balance or hearing structure.

Symptoms

The symptoms include vertigo, imbalance, nausea and vomiting. Some people experience ringing or fullness in the ear with hearing loss. Symptoms often worsen with changes in air pressure (weather changes) along with exertion or activity or in altitude (lifts, airplanes).

Who is affected by perilymph fistula?

Head trauma is the most common cause of fistulas. However they can also develop after rapid or intense changes in intracranial or atmospheric pressure such as SCUBA diving, weightlifting or childbirth. Fistulas can also be present from birth or may result from chronic or a severe ear infections.

How is perilymph fistula diagnosed?

It is diagnosed through assessing the patients’ medical history, physical examination and vestibular and audiometric testing. The only way the diagnosis can be confirmed is via a tympanotomy (operation) and directly viewing the suspected fistula.

Treatment

Usually the fistula will heal itself with strict bed rest. If the symptoms are severe and have not improved with bed rest then surgical repair of the fistula is an option.

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