References to the implication that the disequilibrium of PLF patients are attributable to a specific otolith organ dysfunction are rare [ 92 ], but it is a possibility which warrants further investigation. Australian Journal of Otolaryngology. Very few had an improvement in hearing. There is poor evidence that PLF is a cause of sudden hearing loss, unless there has been a distinct prior traumatic event. Please review our privacy policy. Microfissure in the oval window area.

PLF in children causing hearing loss became a topic of interest in paediatric otolaryngology. Routine window patching when there is no fistula is common and seems certain to confound the interpretation of presenting symptoms, diagnostic tests and outcomes. Tone burst EcochG is a far more sensitive test for the degree hydrops that would be expected in Meniere’s disease, and there is a need for patients a proven PLF to have been tested by this and other techniques [ 90 ]. It seems that office endoscopy of the round and oval windows is usually achievable, but there are conflicting assumptions from what is observed. Australian Journal of Otolaryngology. Current Neurology and Neuroscience Reports. Perilymphatic fistula following airbag trauma.

The anaesthetist was asked to increase the intrathoracic pressure, resulting in recovery of the AP and decrease in the SP when perilymph refilled the otic capsule. Introduction Perilymph fistula PLF has been a controversial issue in otolaryngology now for fifty years.

literature review perilymph fistula

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


Diagnosis of perilymph fistula using ENG and impedance. Otolith Function and Disorders. In the patients no fistula was seen. Journal of Vestibular Research. Animal Studies and Electrocochleography In animal models of PLF caused by removing or breaching the round window membrane in guinea pigs and cats [ peirlymph — 67 ] histology and auditory brainstem hearing thresholds suggest that PLFs can heal, that there may be no long-term hearing loss, and sometimes cochlear hydrops is observed.

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

Classification of vestibular symptoms: In a prospective single-blinded trial, gelfoam was placed in the round and oval windows of patients with a suspected fistula lirerature in patients having other otological procedures.

Annals of Otology, Rhinology and Laryngology. A sixty-eight-year-old man had a year history of disequilibrium and hearing loss. Urban and Schwarzenberg; Clinical Otolaryngology and Allied Sciences. Gelle discovered that in Meniere’s patients manipulation of the stapes could cause vertigo.

When the cause was blunt head trauma the fistula was always at the oval window. In a chinchilla study [ 47 ], intravenous fluoresceine was found to enter perilymph rapidly and long rveiew it reached the CSF, suggesting that perilymph is produced by the cochlea. In Goodlhill’s paper [ 22 ] on sudden sensorineural deafness diagnosed as having PLF two were children with a history of exertion. In all the endoscopy showed no fistula but at tympanotomy there was clear fluid emerging at one or both windows, reinforcing the point that clear fluid may not be perilymph [ 60 ].

literature review perilymph fistula

Cochlin-tomoprotein CTP is a novel perilymph-specific protein, not found in CSF, saliva, or serum [ 56 ] and found in a perilymph leak in a patient with a penetrating ear drum injury [ 57 ] and in some cases of PLF [ 58 ]. The number of PLF explorations per year ranged from none to fifty, with median of five per year. Pseumolabyrinth in perilymphatic fistula: Yanagihara N, Nishioka I. Microfissure in the oval window area.


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

Grundfast and Bluestone [ 32 ] described six children with rapid onset of sensorinerual hearing loss, disequilibrium, or both, with PLF, following exertion or otitis media. A critical literwture of spontaneous perilymphatic fistulas of the inner ear. In early animal experiments using click stimulus EcochG the response did not change unless perilymph was suctioned, suggesting a change in inner ear dynamics.

They commented that the diagnosis is difficult because of the similarity of these symptoms to those of endolymphatic hydrops, a commonly repeated notion that persists to this day. At the round window fistulas are sometimes described as a hole or tear in the round window membrane, but perilympn as a smallbead literahure perilymph emerging from the round window fissure at its inferior edge.

It then became apparent that head trauma and barotraumatic trauma from flying or diving literaure be a cause of PLF. A recurring claim is that individuals with a PLF have endolympahtic hydrops in the affected ear [ 9 ], and that this is the reason for their vestibular symptoms, requires some scrutiny.

Suggestions for progress are offered.

There is poor evidence that PLF is a cause of sudden hearing loss, unless there has been a distinct prior traumatic event. Vestibular effects of chronic perilymph fistula in the cat.