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perilymph labyrinth fistula

Arnaud Deveze, Han Matsuda, Maya Elziere, Tetsuo Ikezono
Perilymphatic fistula (PLF) is defined as an abnormal communication between the fluid (perilymph)-filled space of the inner ear and the air-filled space of the middle ear and mastoid, or cranial spaces. PLF is located in the round or oval window, fractured bony labyrinth, microfissures, anomalous footplate, and can occur after head trauma or barotrauma, chronic inflammation, or in otic capsule dehiscence. This clinical entity was initially proposed more than a century ago, yet it has remained a topic of controversy for more than 50 years...
2018: Advances in Oto-rhino-laryngology
Abiodun D Olusesi, J Abubakar
The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria...
November 2016: European Archives of Oto-rhino-laryngology
Elizabeth J Elliott, David R Smart
Inner ear barotrauma (IEBt) constitutes a spectrum of pressure-related pathology in the inner ear, with antecedent middle ear barotrauma (MEBt) common. IEBt includes perilymph fistula, intralabyrinthine membrane tear, inner ear haemorrhage and other rarer pathologies. Following a literature search, the pathophysiology, diagnosis, and treatment of IEBt in divers and best-practice recommendations for returning to diving were reviewed. Sixty-nine papers/texts were identified and 54 accessed. Twenty-five case series (majority surgical) provided guidance on diagnostic pathways; nine solely reported divers...
December 2014: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Michael Hermann, Daniel H Coelho
OUTCOME OBJECTIVES: To report the case of a contralateral Tullio phenomenon, suggest possible pathophysiology, and give insight into normal vestibular physiology. PATIENTS: Twenty-year-old female subject who presented with 8-month symptoms of left-sided Tullio phenomenon after a motor vehicle collision. Testing suggested a right perilymphatic fistula. INTERVENTION(S): Bedrest and a right perilymphatic fistula repair. MAIN OUTCOME MEASURE(S): Cervical vestibular evoked myogenic potentials (cVEMPs), audiometry, and patient symptoms...
February 2014: Otology & Neurotology
T Langhagen, N Lehnen, E Krause, K Jahn
Migraine equivalents are the most common cause of vertigo in children and adolescents. Vertigo and balance disorders occur frequently in children during the course of otitis media, middle ear effusion and viral infections. If otitis media is associated with reduced hearing and vertigo, labyrinthitis must be considered. Craniocerebral injury is another important cause of vertigo in children. In contrast, spontaneous benign paroxysmal positional vertigo is rare among children. The isolated cases of endolymphatic hydrops that occur in children are usually secondary...
September 2013: HNO
M Achache, M Sanjuan Puchol, L Santini, B Lafont, M Cihanek, J P Lavieille, A Devèze
INTRODUCTION: Temporal bone fracture is a common complication of high-energy cranial trauma. Labyrinth involvement is rare, but there is a risk of perilymphatic rupture that is often underestimated on initial clinical examination due to the predominance of neurological and/or somatic symptoms. CASE REPORT: A patient presented with overlooked perilymphatic fistula, decompensated by hyperpressure effort due to poorly adapted management. DISCUSSION: Following a review of the literature on post-traumatic pneumolabyrinth, overall management (from diagnosis to treatment, via prevention advice) was analyzed...
November 2013: European Annals of Otorhinolaryngology, Head and Neck Diseases
Hassan Al Husban
OBJECTIVE: To study the success results rates and complications of stapedotomy compared to stapedectomy in the operative management of otosclerosis. METHODS: This is a retrospective study of 50 patients who were treated surgically for otosclerosis. The medical records of these patients were reviewed for the type of operation performed, complications and the serial pure tune audiometries pre- and postoperatively for at least one year. Patients with conductive hearing loss not due to otosclerosis were excluded from this study...
January 2013: Oman Medical Journal
Yuko Kataoka, Tetsuo Ikezono, Kunihiro Fukushima, Koji Yuen, Yukihide Maeda, Akiko Sugaya, Kazunori Nishizaki
Perilymphatic fistula (PLF) is defined as an abnormal leakage between perilymph from the labyrinth to the middle ear. Symptoms include hearing loss, tinnitus, and vertigo. The standard mode of PLF detection is intraoperative visualization of perilymph leakage and fistula, which ostensibly confirms the existence of PLF. Other possible methods of diagnosis include confirmation of pneumolabyrinth via diagnostic imaging. Recently, a cochlin-tomoprotein (CTP) detection test has been developed that allows definitive diagnosis of PLF-related hearing loss...
August 2013: Auris, Nasus, Larynx
Thomas Lempert
PURPOSE OF REVIEW: This article describes the common causes of recurrent vertigo and dizziness that can be diagnosed largely on the basis of history. RECENT FINDINGS: Ninety percent of spontaneous recurrent vertigo and dizziness can be explained by six disorders: (1) Ménière disease is characterized by vertigo attacks, lasting 20 minutes to several hours, with concomitant hearing loss, tinnitus, and aural fullness. Aural symptoms become permanent during the course of the disease...
October 2012: Continuum: Lifelong Learning in Neurology
Alex T H Lee
Dizziness is among the commonest of chief complaints. It often presents a significant challenge to the attending physician, because the symptoms and signs are often vague and non-specific. However, a robust systematic approach can usually arrive at the diagnosis. Maintaining balance requires sensory inputs from the vestibular, visual, and somatosensory systems and the cerebellum fine-tunes inaccurate motor outputs. Causes of vertigo are most commonly otological, followed by central, somatosensory, and visual...
August 2012: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Hosuk Chu, Won-Ho Chung
A 42-year-man presented with severe nausea and vertigo, which were precipitated by the application of pressure just anterior to the left external auditory canal. Otoscopic examination revealed a cholesteatoma arising from the pars flaccida of the left tympanic membrane. When pressure was applied to..
January 26, 2012: New England Journal of Medicine
Takuji Koike, Chiaki Sakamoto, Tasuku Sakashita, Ken Hayashi, Sho Kanzaki, Kaoru Ogawa
In this study, a three-dimensional finite-element model of the passive human cochlea was created. Dynamic behavior of the basilar membrane caused by the vibration of the stapes footplate was analyzed considering a fluid-structure interaction with the cochlear fluid. Next, the effects of a perilymphatic fistula (PLF) on the vibration of the cochlea were examined by making a small hole on the wall of the cochlea model. Even if a PLF existed in the scala vestibuli, a traveling wave was generated on the basilar membrane...
January 2012: Hearing Research
Leif Erik Walther
This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab...
2005: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
Tetsuo Ikezono, Susumu Shindo, Kuwon Sekine, Kyoko Shiiba, Han Matsuda, Kaoru Kusama, Yasuo Koizumi, Kazuki Sugizaki, Satomi Sekiguchi, Ryohei Kataoka, Ruby Pawankar, Shunkichi Baba, Toshiaki Yagi, Kimihiro Okubo
CONCLUSIONS: The cochlin-tomoprotein (CTP) detection test can be used to make a definite, objective diagnosis of traumatic perilymphatic fistula (PLF), and therefore offers valuable information on patient selection for surgical treatment. OBJECTIVES: Penetrating middle ear injury can cause traumatic PLF, which is a surgically treatable otologic emergency. Recently, we have reported on CTP, a novel perilymph-specific protein. The purpose of this study was to determine if the CTP detection test is useful for the diagnosis of traumatic PLF...
September 2011: Acta Oto-laryngologica
Nadia Kaffel, Noura Jlassi, Zied Selmi, Riadh Boulakbeche, Rim Lahiani, Dalenda Nejah, Mamia Ben Saleh, Hela Hajri, Mohamed Ferjaoui
BACKGROUND: Post-traumatic peri-lymphatic fistulas have been described following ear and temporal bone injury, particularly in the setting of temporal bone fractures. The symptoms and signs of perilymphatic fistulae (PLF) are very varied and frequently misleading. The diagnosis can be suspected on the bases of the clinical and the audiometrial findings. Indications for exploratory surgery in cases of trauma are vague and not well described. AIM: To assess the principal clinical and radiologic signs of PLF...
May 2011: La Tunisie Médicale
M Al Felasi, G Pierre, M Mondain, A Uziel, F Venail
OBJECTIVE: To highlight diagnostic and treatment pitfalls in perilymphatic fistula. CASE REPORTS: Two cases of round-window fistula are reported, detailing clinical aspect, treatment and outcome. The triad comprising sensorineural hearing loss, tinnitus and vertigo with associated fistula sign is classical but in fact rarely encountered. Imaging is of limited contribution, but may reveal anatomic abnormalities suggestive of perilymphatic fistula. Outcome is improved by early management, especially in case of moderate hearing loss...
June 2011: European Annals of Otorhinolaryngology, Head and Neck Diseases
Marco Mandalà, Liliana Colletti, Marco Carner, Marco Barillari, Roberto Cerini, Roberto Pozzi Mucelli, Vittorio Colletti
Pneumolabyrinth due to late complications of stapes surgery is a rare entity. Symptoms may include various degrees of hearing loss, tinnitus and dizziness. We report the case of a 67-year-old patient who developed a unique pneumolabyrinth variant affecting the vestibule, cochlea and semicircular canals 28 years after stapedectomy. The patient presented with intractable paroxysmal positional vertigo of the lateral semicircular canal. The pneumolabyrinth was visualized by means of high resolution computed tomography...
August 2011: Auris, Nasus, Larynx
Gregor Bachmann-Harildstad, Niels Christian Stenklev, Elin Myrvoll, Greg Jablonski, Olav Klingenberg
OBJECTIVES: The diagnosis of perilymphatic fluid (PLF) fistula is still challenging. Perilymphatic fluid fistula is one possible complication after stapedotomy or cochlear implant surgery. We have performed a prospective diagnostic pilot study to further investigate β-trace protein (β-TP) as a marker for PLF fistula. In this pilot study, we tested the sensitivity of the β-TP marker using a simple method for sample collection from the tympanic cavity. DESIGN: Prospective controlled diagnostic study...
January 2011: Otology & Neurotology
Ektor Tsuneo Onishi, Yotaka Fukuda
UNLABELLED: Perilymphatic fistulas still represent a major treatment challenge. In some cases, its surgical closure can reduce auditory and vestibular sequelae. AIM: To compare the behavior of cochlear window perilymphatic fistulas in guinea pigs as to their natural evolution and immediate surgical closure. MATERIALS AND METHODS: Experimental study. Forty guinea pigs were submitted to cochlear window membrane lesion and randomly broken down into two groups: open fistula (OF) and surgically closed fistula (SCF)...
March 2010: Brazilian Journal of Otorhinolaryngology
Ashley B Robey, Catherine A Craig, Elizabeth R Lyden, Rodney P Lusk
OBJECTIVES/HYPOTHESIS: Although the overall incidence of perilymphatic gushers is approximately 1%, patients with inner ear anomalies are at an increased risk for development of perilymphatic gushers. As cochlear implantation becomes more common in patients with inner ear anomalies (e.g., Mondini defect or common cavity defect), the ability to successfully seal such leaks becomes of paramount importance to reduce the risk of subsequent meningitis. METHODS: A 1.0-mm and a 1...
February 2010: Laryngoscope
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