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Case Rep Otolaryngol 2020 9;2020:9476915. Epub 2020 Mar 9.

Department of Otolaryngology, Saitama Medical University, Saitama, Japan.

We present a case of perilymphatic fistula (PLF) with inner ear anomalies having sudden, progressive sensorineural hearing loss and describe the fistula repair surgeries. We focus on the diagnosis methods of PLF and clinical course of PLF with inner ear anomaly. The cochlin-tomoprotein (CTP) detection test is very useful for the surgeons to encourage the earlier operation to sudden hearing loss cases. Read More

Acta Otolaryngol 2020 Apr 21;140(4):262-269. Epub 2020 Jan 21.

Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France.

Delayed 3D-FLAIR sequences enable the distinction between the utricle and the saccule. We sought to evaluate the clinical and radiological findings in patients with no visible saccule (NVS) on 4-hour post-contrast MRI. We retrospectively assessed the presence of NVS signs in 400 patients who underwent delayed inner ear MRI. Read More

Vestn Otorinolaringol 2019 ;84(3):61-64

ENT department of Rostov State Medical University, Rostov-on-Don, Russia, 344022.

A case of perilymphatic fistula with the luxation of the stapes into vestibule was described, which was caused by a direct damage of the eardrum (the patient cleaned the right ear with a cotton swab and received a strong blow to the arm). The moment of injury was characterized by severe pain, a significant hearing loss, the appearance of tympanophonia and vertigo. Clinical examination revealed the eardrum rupture. Read More

Clin Pract Cases Emerg Med 2019 May 4;3(2):115-118. Epub 2019 Mar 4.

David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California.

Pneumolabyrinth, defined as air within the labyrinth on high-resolution computed tomography, suggests that a perilymphatic fistula (PLF) is present. PLF describes an abnormal communication between the middle and inner ear, and can result in deafness, vertigo, and imbalance. In the setting of a penetrating injury to the temporal bone or inner ear, pneumolabyrinth should trigger prompt otolaryngology consultation and urgent surgical exploration. Read More

Adv Otorhinolaryngol 2019 15;82:93-100. Epub 2019 Jan 15.

Perilymphatic fistulas (PLF) and superior semi-circular canal dehiscence syndrome (SCDS) are 2 conditions that can present with sound and/or pressure-induced vertigo. PLF should be suspected in cases of trauma or surgery, while a spontaneous PLF is a diagnosis of exclusion. Research is ongoing to identify an ideal biomarker for perilymph. Read More

Otol Neurotol 2019 04;40(4):e356-e363

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.

Objective: To analyze surgical results on hearing and vestibular symptoms in patients with barotraumatic perilymphatic fistula (PLF) according to diagnostic criteria.

Methods: A total of 39 patients (41 ears) who underwent surgery on suspicion of barotraumatic PLF from January 2005 to December 2017 were included. Pure tone audiometry and videonystagmography (VNG) recording for spontaneous nystagmus and positional tests were performed preoperatively and postoperatively at 1 week and 1 month. Read More

BMJ Case Rep 2019 Mar 1;12(3). Epub 2019 Mar 1.

Otorhinolaryngology - Head & Neck Surgery, Hospital de Braga, Braga, Portugal.

Post-traumatic pneumolabyrinth is an uncommon clinical entity, particularly in the absence of temporal bone fracture. We report the case of a patient who presented to our emergency department with a headache, sudden left hearing loss and severe dizziness which began after a traumatic brain injury 3 days earlier. On examination, the patient presented signs of left vestibulopathy, left sensorineural hearing loss and positive fistula test, normal otoscopy and without focal neurological signs. Read More

Front Neurol 2019 30;10:47. Epub 2019 Jan 30.

Department of Otolaryngology, Kindai University Faculty of Medicine, Osaka, Japan.

An 8-year-old boy was referred to the ENT department for further evaluation of right-sided conductive hearing loss. A small cyst anterior to the oval window and fixation of the stapes footplate were observed during an exploratory tympanotomy. The concentration of a perilymph-specific protein, cochlin-tomoprotein (CTP), in the middle ear lavage fluid was measured with an ELISA-based CTP detection kit. Read More

Adv Otorhinolaryngol 2018 6;81:133-145. Epub 2018 Apr 6.

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. Read More

J Int Adv Otol 2018 Apr;14(1):106-111

Department of Neurosciences, Institute of Otolaryngology, Padova University School of Medicine, Padova, Italy.

The goal of the present study was to describe a case of perilymphatic fistula (PLF) of the round window (RW) that occurred after sneezing, along with a review of the literature. We report a case of PLF of RW, which was provoked by sneezing, and its consequent medical and surgical treatments. With respect to the review of the literature, articles were initially selected based on their titles or abstracts, followed by methodological evaluation. Read More

Am J Otolaryngol 2018 Jan - Feb;39(1):46-49. Epub 2017 Oct 9.

Department of Otolaryngology - Head and Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel. Electronic address:

Purpose: The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome.

Study Design: Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005.

Settings: Tertiary care university-affiliated hospital. Read More

Diagn Interv Imaging 2017 Oct 20;98(10):699-706. Epub 2017 Jun 20.

Department of neuroradiology and MRI, Grenoble Alpes university hospital-SFR RMN neurosciences, 38000 Grenoble, France; University Grenoble Alpes, IRMaGe, 38000 Grenoble, France.

Purpose: The goal of this retrospective study was to investigate the differential diagnosis of endolymphatic hydrops in patients with Meniere's disease (MD) symptoms by using magnetic resonance imaging (MRI) with intravenous injection of gadolinium chelate and delayed acquisition.

Material And Method: Two hundred patients (133 women, 67 men; mean age=67.2±11 ([SD] years) with unilateral MD underwent MRI at 3-T, between 4. Read More

Acta Otolaryngol 2017 3;137(sup565):S53-S59. Epub 2017 Apr 3.

a Department of Otorhinolaryngology , Saitama Medical University , Moroyama , Japan.

Objective: To investigate the positive rate for the Cochlin tomo-protein (CTP: an inner ear-specific protein) detection test among patients with inner ear-related clinical manifestations and evaluate the clinical characteristics of definite perilymphatic fistula (PLF).

Methods: We have performed an ELISA-based CTP detection test using middle ear lavage (MEL) samples from 497 cases of suspected PLF enrolled from 70 clinical centers nationwide between 2014 and 2015. In addition to the CTP-positive rate, audio-vestibular symptoms were compared between CTP-positive and -negative cases. Read More

Otol Neurotol 2017 02;38(2):168-172

*Department of Otolaryngology, Head and Neck Surgery†Department of Medical Imaging, Fondation A. de Rothschild, Paris, France.

Background: Sensorineural complications of stapes surgery are rare but potentially serious. Imaging is usually performed to identify an underlying cause, such as excessive intravestibular penetration of the prosthesis or pneumolabyrinth suggesting perilymphatic fistula. Unfortunately, there is very little data in an unselected series of uneventful patients. Read More

J Laryngol Otol 2016 Dec 29;130(12):1158-1161. Epub 2016 Nov 29.

Division of Otolaryngology,Mount Sinai Medical Center,Miami Beach,Florida,USA.

Objective: To assess an alternative to bed rest and surgery for suspected perilymphatic fistulas using intratympanic blood injections.

Method: A review was conducted of patients' history, physical and audiometric data, before and after treatment by intratympanic blood injections performed from 2009 to 2015.

Results: Twelve ears were identified, with trauma associated with air travel, water sports or nose blowing. Read More

Diving Hyperb Med 2016 Jun;46(2):72-5

Ear, Nose and Throat, and Cervicofacial Surgery.

Introduction: Onset of cochleovestibular symptoms (hearing loss, dizziness or instability, tinnitus) after a dive (scuba or breath-hold diving) warrants emergency transfer to an otology department. One priority is to investigate the possibility of the development of decompression sickness with a view to hyperbaric oxygen treatment of bubble-induced inner-ear damage. If this injury is ruled out, inner-ear barotrauma should be considered together with its underlying specific injury pattern, perilymphatic fistula. Read More

Acta Otolaryngol 2016 Nov 31;136(11):1193-1195. Epub 2016 May 31.

a Department of Otorhinolaryngology , Showa University , Tokyo , Japan.

Objectives: The authors would like to confirm a fluid pathway from the scala tympani to the organ of Corti, and to observe its morphological changes.

Methods: A staining solution for succinic dehydrogenase was perfused with phenazine methosulfate in the scala tympani of living guinea pigs (n = 5) under deep anesthesia. After fixation, the cochleas were eventually embedded in epon. Read More

Adv Otorhinolaryngol 2016 26;77:23-6. Epub 2016 Apr 26.

Pneumolabyrinth is a rare condition with air bubbles existing in the vestibule and/or cochlea. We report a case of pneumolabyrinth without trauma that was suspected to be caused by labyrinthitis. A 65-year-old man presented with vertigo and hearing loss in the left ear after catching a cold. Read More

J Laryngol Otol 2016 Jun 26;130(6):526-31. Epub 2016 Apr 26.

Department of Otolaryngology,James Paget University Hospital,Great Yarmouth,UK.

Objective: This study aimed to assess the experiences and outcomes of patients who underwent surgical repair of a perilymph fistula in Norfolk, UK.

Methods: The study involved a retrospective questionnaire-based patient survey and case note review of patients who had undergone tympanotomy and perilymph fistula repair between 1998 and 2012 in two district general hospitals.

Results: Fourteen patients underwent 20 procedures, of whom 7 completed the pre- and post-operative Vertigo Symptom Scale. Read More

Insights Imaging 2016 Jun 16;7(3):341-50. Epub 2016 Apr 16.

Department of Neuroradiology and MRI, Grenoble University Hospital - SFR RMN Neurosciences, Grenoble, France.

Unlabelled: Hearing loss is a common functional disorder after trauma, and radiologists should be aware of the ossicular, labyrinthine or brain lesions that may be responsible. After a trauma, use of a systematic approach to explore the main functional components of auditory pathways is essential. Conductive hearing loss is caused by the disruption of the conductive chain, which may be due to ossicular luxation or fracture. Read More

Otol Neurotol 2016 06;37(5):598-601

*Department of Otorhinolaryngology-Head and Neck Surgery †Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands ‡Division of Otolaryngology, Department of Surgery §School of Biomedical Engineering and Department of Electrical and Computer Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.

Hypothesis: Round window reinforcement leads to conductive hearing loss.

Background: The round window is stiffened surgically as therapy for various conditions, including perilymphatic fistula and superior semicircular canal dehiscence. Round window reinforcement reduces symptoms in these patients. Read More

Laryngoscope 2016 12 12;126(12):2823-2826. Epub 2016 Mar 12.

Department of Otorhinolaryngology-Head and Neck Surgery, The Paracelsus Private Medical University of Salzburg, Salzburg, Austria.

The cause of unilateral sudden sensorineural hearing loss (SNHL) remains unclear in many clinical cases. Perilymphatic leakage through a fissula ante fenestram (FAF) fistula is one possible reason. We present four clinical cases with proven FAF fistula, discovered during surgical exploration. Read More

Int Arch Otorhinolaryngol 2015 Apr 12;19(2):183-6. Epub 2014 Dec 12.

Department of Otolaryngology and Skull Base Surgery, University Hospital Nord, Marseille, France ; Laboratory of Applied Biomechanics IFSTTAR, Aix Marseille University, Bd Pierre Dramard, Marseille, France.

Introduction Traumatic perilymphatic fistula is not a rare event with regards to sport activities or traffic accident. However, iatrogenic damage to the inner ear can occur following the common use of grommets and ventilation tube insertion. Objectives To report an unusual case of insertion of aeration tube into the vestibule trough the stapes footplate. Read More

Curr Treat Options Neurol 2015 Apr;17(4):341

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA,

Opinion Statement: Diagnosis of Menière's disease is made with a characteristic patient history, including discrete episodes of vertigo lasting 20 min or longer, accompanied by sensorineural hearing loss, which is typically low frequency at first, aural fullness, and tinnitus. Workup includes audiometry, a contrast enhanced MRI of the internal auditory canals, and exclusion of other diseases that can produce similar symptoms, like otosyphilis, autoimmune inner ear disease, perilymphatic fistula, superior semicircular canal syndrome, Lyme disease, multiple sclerosis, vestibular paroxysmia, and temporal bone tumors. A history of migraine should be sought as well because of a high rate of co-occurrence (Rauch, Otolaryngol Clin North Am 43:1011-1017, 2010). Read More

Eur Rev Med Pharmacol Sci 2014 ;18(23):3549-50

Otolaryngology and Radiology; University Campus Bio-Medico of Rome, Rome, Italy.

Perilymphatic fistula (PLF) is an abnormal condition in which a communication is present between the perilymphatic space of the inner ear and the middle ear or mastoid, secondary to a dehiscence in the otic capsule, oval or round window. LF may induce hearing loss, tinnitus, aural fullness, vertigo, disequilibrium, or a combination of these symptoms; the vagueness of symptoms caused by PLF and the lack of specificity of clinical signs and symptoms make the diagnosis elusive. We report a video of a positive PLF test induced by the application of pressure on the tragus, just anterior to the left external auditory canal in a patient with cholesteatoma and PLF of lateral semicircular canal confirmed by CT scan imaging. Read More

Am J Otolaryngol 2014 Nov-Dec;35(6):822-5. Epub 2014 Jul 10.

1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 1, Stilponos Kyriakidi St., GR Thessaloniki, Greece. Electronic address:

Perilymphatic fistula is usually associated with sudden or fluctuating sensorineural hearing loss. We present a case of whiplash injury in a patient who showed conductive hearing loss at low frequencies due to a perilymphatic fistula occurring in the round window. Although no middle ear pathology was found, the symptoms and laboratory findings were mimicking the so called "third mobile window" phenomenon, but without the presence of inner ear dehiscence. Read More

Otol Neurotol 2014 Dec;35(10):1797-800

ENT Department, Hospital Clínic, University of Barcelona Medical School, Barcelona, Spain.

Introduction: A partially or fully absent or largely perforated footplate is a challenging condition that may be encountered during middle ear surgery, especially in patients with a history of chronic ear problems or with previous tympanoplasties.

Materials And Methods: Retrospective study on a limited number of cases undergoing revision tympanoplasty in which a new footplate was created from the cartilage, and the ossicular chain was reconstructed with a titanium prosthesis in 1 stage. Minimum follow-up was 24 months. Read More

Eur Arch Otorhinolaryngol 2015 Aug 21;272(8):1885-91. Epub 2014 Mar 21.

Division of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center (CHUM), University of Montreal, 1560, Sherbrooke East Street, Montreal, QC, H2L 4M1, Canada.

This study intends to identify factors that could better predict the diagnosis of perilymphatic fistula (PLF) since exploration surgery is currently the only confirmatory method. This retrospective chart review in a tertiary care center is based on all 71 available patient files operated for a suspicion of PLF between 1983 and 2012. History of predisposing factors, clinical findings and investigations were documented pre- and postoperatively. Read More

Otol Neurotol 2014 Apr;35(4):582-8

European Institute for Otorhinolaryngology, Wilrijk, Antwerp, Belgium.

Objective: Stapediovestibular luxations are rare lesions that are most commonly caused by direct, penetrating trauma to the external ear canal. In this type of ossicular dislocation, disruption of the annular ligament or footplate fracture may lead to a perilymphatic fistula (PLF) presenting with cochleovestibular symptoms including (progressive) sensorineural hearing loss, tinnitus, and vestibular symptoms. The objective of this article is to define the optimal treatment of stapediovestibular luxations and review the literature on this topic. Read More

Otol Neurotol 2014 Feb;35(2):301-4

Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.

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. Read More

Eur Arch Otorhinolaryngol 2015 Feb 11;272(2):303-9. Epub 2013 Dec 11.

Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland,

To elucidate the communication between the middle and inner ear, and the fluid dynamics of the inner ear with the perilymphatic fistula (PLF) of the round window membrane (RWM). The PLF of the RWM was created in nine guinea pigs. Gadolinium diethylenetriamine pentaacetic acid bismethylamide (Gd-DTPA-BMA) was delivered into the middle ear and followed in the inner ear using a 4. Read More

Semin Neurol 2013 Jul 21;33(3):238-43. Epub 2013 Sep 21.

Barrow Neurological Institute, Phoenix, Arizona.

Dizziness and vertigo are common symptoms following minor head trauma. Although these symptoms resolve within a few weeks in many patients, in some the symptoms may last much longer and impede ability to return to work and full functioning. Causes of persisting or recurrent dizziness may include benign paroxysmal positional vertigo, so-called labyrinthine concussion, unilateral vestibular nerve injury or damage to the utricle or saccule, perilymphatic fistula, or less commonly traumatic endolymphatic hydrops. Read More

J Head Trauma Rehabil 2014 Sep-Oct;29(5):432-42

Departments of Psychiatry and Psychotherapy (Drs Kreuzer, Landgrebe, and Langguth) and Otolaryngology (Dr Vielsmeier), University of Regensburg, Regensburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg, Germany (Dr Landgrebe); Department of Otolaryngology, University of Zurich, Zurich, Switzerland (Dr Kleinjung); Brain Research Center Antwerp for Innovative & Interdisciplinary Neuromodulation, Antwerp, Belgium; and Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Dr De Ridder).

Background: Up to 53% of individuals suffering from traumatic brain injuries develop tinnitus.

Objective: To review the current literature on trauma-associated tinnitus in order to provide orientation for the clinical management of patients with trauma-associated tinnitus.

Materials: A systematic literature search has been conducted in PubMed database applying the search terms posttraumatic tinnitus and trauma-associated tinnitus. Read More

Neuroradiol J 2013 Feb 8;26(1):52-5. Epub 2013 Mar 8.

Department of Otorhinolaryngology, University Hospital of Catania; Catania, Italy.

Blunt head trauma without any temporal bone fracture or longitudinal temporal bone fracture, with an associated fracture of the labyrinth may cause labyrinthine injury with sensor neural hearing loss and vertigo because of a concussive injury to the membranous labyrinth. Sudden sensory neural hearing loss is relatively frequent. In most cases, the etiology is not discovered. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2013 Nov 10;130(5):283-7. Epub 2013 Jun 10.

Service d'Oto-Rhino-Laryngologie et Chirurgie de la Face et du Cou, Assistance Publique-Hôpitaux de Marseille, CHU Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.

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. Read More

Otol Neurotol 2013 Jun;34(4):639-43

Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objective: Pneumolabyrinth resulting from temporal bone trauma and stapes luxation has been associated with sensorineural hearing loss (SNHL). The principal purpose of this study was to determine the incidence and volume of pneumolabyrinth after stapedotomy in which iatrogenic perilymphatic fistula is created and to also correlate this with possible hearing loss and vertigo.

Study Design: Prospective study. Read More

BMC Ear Nose Throat Disord 2012 Nov 29;12:14. Epub 2012 Nov 29.

Department of Otorhinolaryngology, University of Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg 93053, Germany.

Unlabelled:

Background: Aim of the present study was to evaluate the occurence of a round window membrane rupture and the effects of hearing restoration after exploratory tympanotomy and sealing of the round window (niche) in patients with unilateral sudden deafness.

Methods: Retrospective analysis of patients' charts in a tertiary referral center. Charts of 69 patients with sudden deafness followed by exploratory tympanotomy were retrospectively analyzed. Read More

Otol Neurotol 2012 Oct;33(8):1408-11

Department of Otolaryngology, Middle Ear Surgical Center, Takanoko Hospital, Matsyama City, Japan.

Objectives: Here, we report a case of pneumolabyrinth induced by Eustachian tube air inflation (ETAI) with a catheter and present evidence that multiple air bubbles entered the perilymphatic space through a preexisting oval window fistula.

Setting: Tertiary referral center.

Patient: Sixty-six-year-old woman. Read More

Emerg Radiol 2012 Dec 26;19(6):557-60. Epub 2012 May 26.

Radiology Department, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey.

Sensorineural hearing loss (SNHL) can develop after trauma and determination of its etiology is crucial for treatment planning. Computed tomography (CT) is the first-line imaging method in evaluation of trauma victims; however, its value is limited in visualization of perilymphatic fistula or in assessment of cochlear implant candidates. Herein, we present imaging findings of a patient with traumatic bilateral transverse fractures of temporal bones and resultant SNHL. Read More

Acta Otolaryngol 2012 Jun 4;132(6):676-82. Epub 2012 Mar 4.

Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto city, Japan.

Abstract Usage of the Vibrant Soundbridge (VSB) with round window (RW)-Coupler placement at the RW has been shown to successfully treat mixed hearing loss. Coupling between the VSB's floating mass transducer (FMT) and the RW membrane is difficult in the case of sclerosis in the RW and drilling down the bony lip until the RW membrane can be seen completely can possibly induce a perilymphatic fistula. A 68-year-old woman who had bilateral mixed hearing loss with sclerosis in the RW due to tympanosclerosis underwent a RW-Vibroplasty with a RW-Coupler. Read More

Laryngoscope 2012 Feb 17;122(2):412-4. Epub 2012 Jan 17.

Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.

Superior semicircular canal dehiscence (SSCD) syndrome has been called the great otologic mimicker because its presentation overlaps with otosclerosis, Meniere's disease, perilymphatic fistula, and patulous eustachian tube. A valuable examination finding that can help distinguish SSCD syndrome from other pathologic conditions is the presence of Hennebert's sign, in which pressure changes in the external auditory canal evoke stereotyped eye movements that align in the plane of the dehiscent semicircular canal. This video case report demonstrates Hennebert's sign associated with SSCD syndrome and discusses its pathophysiological basis. Read More

Rev Laryngol Otol Rhinol (Bord) 2012 ;133(4-5):171-6

Hôpital d'Instruction des Armées Sainte Anne, Service ORL et CCF, 83000 Toulon, France.

Introduction: When facing cochleovestibular symptoms such as hearing loss, dizziness or unsteadiness, or a tinnitus evolving in the aftermath of a cranial trauma or overpressure in the form of inner ear barotrauma after diving or a from blast, a perilymphatic fistula must be considered.

Materials And Methods: We present a homogenous prospective series of 16 cases of perilymphatic fistulae occurring after head trauma or overpressure between 2003 and 2011. Patients suspected of suffering from a perilymphatic fistula and presenting with the following criteria were included: the occurrence after a variable delay of cochleovestibular symptoms (vertigo, tinnitus, and hearing loss) in the aftermath of a head trauma or overpressure. Read More

Int Tinnitus J 2012 ;17(1):58-63

Perilymphatic Fistula (PLF) remains a controversial topic and its management is challenging. Various etiologic events have been proposed and spontaneous PLF has been described 1. Diagnostic methods and strategies have been reported in the literature but no standard algorithm exists. Read More

Hear Res 2012 Jan 15;283(1-2):117-25. Epub 2011 Nov 15.

Department of Mechanical Engineering and Intelligent Systems, Graduate School of Informatics and Engineering, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan.

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. Read More

Otol Neurotol 2011 Oct;32(8):1270-2

Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan 48109-5312, USA.

Objective: Document the use of transcanal labyrinthectomy to treat disabling attacks of vertigo after unilateral cochlear implantation.

Patient: A 46-year-old woman with severe-profound bilateral sensorineural hearing loss secondary to enlarged vestibular aqueducts underwent cochlear implantation for her right ear with a Nucleus Freedom device. The surgery was uneventful, and postoperative imaging confirmed that the electrode was positioned properly. Read More

Eur Arch Otorhinolaryngol 2012 Apr 14;269(4):1085-90. Epub 2011 Sep 14.

Department of Cervico-Facial Surgery and ENT at University CFR Hospital Cluj-Napoca, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.

The management of labyrinthine fistula is a controversial issue. Hearing preservation represents a major challenge. Retrospective study of 31 patients with labyrinthine fistula confirmed intra-operatively during cholesteatoma surgery. Read More

Ear Nose Throat J 2011 May;90(5):E28-31

Department of Diagnostic Radiology, Singapore General Hospital, Singapore.

A penetrating ear injury with a perilymphatic fistula is not an uncommon occurrence in otolaryngologic practice, but stapes luxation is rare. We report the case of an 11-year-old boy who developed a traumatic perilymphatic fistula secondary to an atypical stapes luxation into the vestibule. After sustaining a penetrating injury to the right ear, the patient presented with otalgia, vertigo, vomiting, gait unsteadiness, and hearing loss. Read More

Laryngoscope 2011 Apr 8;121(4):856-9. Epub 2011 Feb 8.

Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.

A perilymphatic fistula (PLF) is an abnormal communication between the inner and middle ear resulting in vestibular or cochlear symptoms. We review three pediatric traumatic temporal bone fractures with pneumolabyrinth, confirmed radiologically by the presence of air within the cochlea (pneumocochlea) or vestibule (pneumovestibule). Patients were treated conservatively with complete resolution of vestibulopathy. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2011 Jun 1;128(3):139-41. Epub 2011 Feb 1.

Service ORL et Centre d'Implantation Cochléaire, CHU Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.

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. Read More

Auris Nasus Larynx 2011 Aug 13;38(4):547-50. Epub 2011 Jan 13.

ENT Department, University of Verona, Italy.

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. Read More