Two papers have focussed on head trauma and whiplash as a cause of PLF. Quantitative diagnostic test for perilymph fistulas. Surgical management of perilymphatic fistulas: Both windows were patched regardless of the findings. International Journal of Pediatric Otorhinolaryngology. Microfissure in the oval window area. Gulya and colleagues [ 70 ] also performed click stimulus EcochG in guinea pigs before and after creation of a round window fistula with a hook, but without suction.

The volume of perilymph is estimated to be approximately 75 microlitres, so confirming a leak usually entails visualizing a tiny quantity of fluid, unless it is dramatic which probably means a CSF leak. Journal of Neurology Neurosurgery and Psychiatry. When the cause was barotrauma, exertion or unknown was always at the round window. This article has been cited by other articles in PMC. The decision to consider a PLF repair is guided by a positive fistula test or an immediate onset of Meniere’s disease symptom complex after head or ear trauma.

Traumatic perilymphatic fistula secondary to stapes luxation into the vestibule: As far as therapy is concerned, surgical treatment can be performed and the perilymph fistula thus represents one of the few causes of sensorineural hearing loss that can be treated surgically.

There is good evidence that head trauma even mild and whiplash can initiate the onset of a PLF. Australian Journal of Otolaryngology.

After an inner ear injury, there is nearly always recovery or central adaption. Institutional Series The recognition that PLF could occur without stapes surgery or trauma initiated widespread interest, resulting literatrue numerous institutional reports on their experience and results, particularly in the United States, Seltzer and McCabe [ 13 ].

literature review perilymph fistula

Platform pressure test in identificaztion of perilymphatic fistula. Many authors emphasise that such likely event can be forgotten, or even concealed by the patient. The new perilymph-specfic CTP [ 56 — 58 ] shows some promise but will require verification from other centres.


Since it is often difficult to distinguish patients with PLFs and secondary endolymphatic hydrops Meniere’s syndrome from patients fistual Meniere’s disease idiopathic endolymphatic hydropsPLF repair is a reasonable first operation, reserving an endolymphatic sac-mastoid shunt operation as a secondary procedure if needed.

Standard technique for visually confirming a fistula is prolonged examination with microscope and asking the anaesthetist to increase intrathoracic pressure.

In those where a fistula was found one third had no history of ear surgery or trauma. Abstract Perilymph fistula PLF is defined fiwtula a leak of perilymph at the oval or round window.

literature review perilymph fistula

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 ]. In general the round window could nearly always be viewed by a 5 degree rigid scope and the fissula ante fenestram edge of the oval window by a 25 degree scope. There is evidence that barotrauma diving, sneezing coughing, labor, and acoustic trauma can initiate a PLF.

Perilymph Fistula: Fifty Years of Controversy

Otolith Function and Disorders. The evidence for this came from temporal bone histology, which is time-intensive and expensive. Endoscopic diagnosis of idiopathic perilymphatic fistula.

literature review perilymph fistula

Preilymph improvement from a PLF repair of any cause is rare, but that is not a reason not to explore the ear if there is strong evidence and a likelihood of the hearing loss advancing. The most commonly employed chemical test to distinguish perilymph from other fluids has been beta-transferrin, which is in perilymph and cerebrospinal fluid CSF but not plasma.

Microfissure between the round window niche and posterior canal ampulla. These findings were the impetus for Kohut’s temporal bone studies on patients who might oerilymph had a PLF [ 29 ]. Bilateral perilymph fistulas from a lightening strike: Role of transtympanic endoscopy literatute the middle ear in the diagnosis of perilymphatic fistula in patients with sensorineural hearing loss or vertigo.


Acknowledgments The author thanks the staff of the Canterbury Medical Library for their assistance in obtaining the papers used for this review. Very fkstula had an improvement in hearing. 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.

Congenital and acquired perilymph fistula: review of the literature.

Selmani perilymhp colleagues [ 63 ] endoscoped one ear of two hundred and sixty-five patients with Meniere’s disease, recurrent vertigo, progressive hearing loss, sudden deafness, otosclerosis, and suspected PLF. Fluorescein kinetics in perilymph and blood: The perilymph fistula syndrome defined in mild head trauma.

After a stapedotomy there was no change in the EcochG unless perilymph was suctioned when there was dramatic decrease in the size of the AP and increase in the SP. In early animal experiments using click stimulus EcochG the response did not change unless perilymph was suctioned, suggesting a change in inner ear dynamics. The acquired fistula can be caused by iatrogenic trauma, physical injury or erosion.

Congenital and acquired perilymph fistula: review of the literature.

The slipped strut problem, a review of 52 cases. The theory proposes that a force up an abnormally patent cochlear aqueduct could rupture the basilar membrane and Reisner’s membrane into the scala vestibuli, and conceivably injure the utricle, saccule, the semicircular canal system, the round window membrane, or the annular ligament of the stapes.

Relevance of the Tullio phenomenon in assessng perilymphatic leak in vertiginous patients.