Role of Transtympanic Endoscopy of the Middle Ear in the Diagnosis of Perilymphatic Fistula in Patients with Sensorineural Hearing Loss or Vertigo

Selmani, Ziane; Pyykkö, Ilmari; Ishizaki, Hisayoshi; Marttila, Timo

doi:10.1159/000066074

Cited by 19 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Karhuketo and Puhakka [62] have endoscopically repaired an round window fistula in a diver. Selmani and 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. 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.…”

Section: Operative Confirmation Of Plfmentioning

confidence: 99%

Perilymph Fistula: Fifty Years of Controversy

Hornibrook

2012

ISRN Otolaryngology

View full text Add to dashboard Cite

Perilymph fistula (PLF) is defined as a leak of perilymph at the oval or round window. It excludes other conditions with “fistula” tests due to a dehiscent semi circular canal from cholesteatoma and the superior canal dehiscence syndrome. It was first recognized in the early days of stapedectomy as causing disequilibrium and balance problems before sealing of the stapedectomy with natural tissue became routine. It then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause of PLF. Descriptions of “spontaneous” PLF with no trauma history followed. A large literature on PLF from all causes accumulated. It became an almost emotional issue in Otolaryngology with “believers” and “nonbelievers.” The main criticisms are a lack of reliable symptoms and diagnostic tests and operative traps in reliably distinguishing a perilymph leak from local anaesthetic. There are extensive reviews on the whole topic, invariably conveying the authors' own experiences and their confirmed views on various aspects. However, a close examination reveals a disparity of definitions and assumptions on symptoms, particularly, vestibular. This is an intentionally provocative paper with suggestions on where some progress might be made.

show abstract

Section: Operative Confirmation Of Plfmentioning

confidence: 99%

Perilymph Fistula: Fifty Years of Controversy

Hornibrook

2012

ISRN Otolaryngology

View full text Add to dashboard Cite

show abstract

“…focused their study on the detection of perilymphatic fistula and not on hearing results after successful sealing of the round window membrane. 24 Additionally, all patients underwent exploratory tympanotomy by endoscopy, regardless of the cause of the hearing loss. This study's design did not meet our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Exploratory tympanotomy in sudden sensorineural hearing loss for the identification of a perilymphatic fistula – retrospective analysis and review of the literature

et al. 2020

View full text Add to dashboard Cite

AbstractObjectiveThe diagnostic value of exploratory tympanotomy in sudden sensorineural hearing loss remains controversial. This study and review were performed to identify the incidence of perilymphatic fistula in patients with sudden sensorineural hearing loss. The effectiveness of tympanotomy for sealing of the cochlear windows in cases with perilymphatic fistula was evaluated.MethodsA search in common databases was performed. Overall, 5034 studies were retrieved. Further, a retrospective analysis on 90 patients was performed.ResultsEight publications dealing with tympanotomy in patients with sudden sensorineural hearing loss were identified. In 90 patients diagnosed with sudden sensorineural hearing loss and undergoing exploratory tympanotomy, 10 patients (11 per cent) were identified with a perilymphatic fistula, and this corresponds to the results obtained from our review (13.6 per cent).ConclusionThere was no significant improvement after exploratory tympanotomy and sealing of the membranes for patients with a definite perilymphatic fistula.

show abstract

“…There are a few retrospective studies that analyzed hearing after tympanotomy [14,15,20]. Selmani et al, who performed an endosopic inspection of the middle ear cavity, observed no perilymphatic fistula in 265 cases of patients with SSNHL and vertigo [21]. With respect to the well-established microsurgery of the middle ear and the possible infection during a middle ear endoscopy, we prefer the better visualization of the round window membrane via the operation microscope.…”

Section: Discussionmentioning

confidence: 99%

Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss

Haubner

Rohrmeier

Koch

et al. 2012

BMC Ear Nose Throat Disord

View full text Add to dashboard Cite

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. Pure-tone audiometry data before and after tympanotomy were compared to determine the outcome of hearing recovery. The postoperative hearing test values were documented 3 weeks after tympanotomy. All surgical reports were reviewed with regard to the surgical technique performed and the intraoperative findings. Results: 18.8% of the patients revealed a visible perilymphatic fistula in the round window niche. 89.8% of the patients reported no typical history for a round window membrane rupture. All patients were treated with an exploratory tympanotomy under local anesthesia and an intravenous corticosteroid treatment regimen. The majority of the surgeons used a fat plomb to cover the round window. Postoperative hearing was significantly improved compared to the preoperative hearing test data. No patient showed a worsened hearing curve after the treatment. Conclusion: Most patients suffering from unilateral sudden deafness had no visible perilymphatic fistula. In our study population, the majority of patients reported no typical history of a pressure elevation in the inner ear. Exploratory tympanotomy is a safe procedure that may support hearing recovery in patients with sudden deafness in addition to the established treatment regimen including high-dose steroids.

show abstract

Role of Transtympanic Endoscopy of the Middle Ear in the Diagnosis of Perilymphatic Fistula in Patients with Sensorineural Hearing Loss or Vertigo

Cited by 19 publications

References 21 publications

Perilymph Fistula: Fifty Years of Controversy

Perilymph Fistula: Fifty Years of Controversy

Exploratory tympanotomy in sudden sensorineural hearing loss for the identification of a perilymphatic fistula – retrospective analysis and review of the literature

Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss

Contact Info

Product

Resources

About