Perilymphatic Fistula
Background:
Diagnosis:
Treatment:
Special Tests:
Valsalva Test
- A perilymphatic fistula is defined as an abnormal communication between the middle ear and inner ear. This miscommunication is caused by a hole in the otic capsule, oval or round window. This condition can be either congenital or acquired. An acquired perilymphatic fistula is most generally caused by a traumatic event. Other sources of perilymphatic fistula include idiopathic and erosive causes (Fitzgerald, 1995).
- Vertigo (Prisman, 2011)
- Sensorineural hearing loss (Prisman, 2011)
- Tinnitus (Prisman, 2011)
Diagnosis:
- There are several tests that can be ran to accurately diagnose a perilymphatic fistula (Gulya, 1994):
- Valsalva test- looking for superior canal dehiscence
- Audiometry
- Electrocochleography
- Electronystagmography
- Temporal Bone CT Scan
- MRI Scan
- Vestibular Evoked Myogenic Potential
- Cochlin-tomoprotein (CTP) detection test- used to diagnose traumatic perilymphatic fistula
- Cochlin-tomoprotein is a novel perilymph special protein that, when found in the middle ear, is indicative of perilymphatic fistula (Ikezono, 2011).
- Cochlin-tomoprotein is a novel perilymph special protein that, when found in the middle ear, is indicative of perilymphatic fistula (Ikezono, 2011).
Treatment:
- Conservative treatment includes activity restrictions and certain precautions, such as not traveling by airplane. The goal of conservative treatment is to provide the body an ideal environment so that it can heal itself.
- Generally, a period of six months is given before considering surgical repair. The surgical procedure takes approximately one hour (Whitney, 2001).
Special Tests:
Valsalva Test
- Positive pressure is produced against pinched nostrils.
- A positive test is indicated by down-beating nystagmus during positive pressure and/or up-beating nystagmus when the patient produces negative pressure against a closed glottis.