Spontaneous perilymph fistulas

Stroud, Malcolm H.; Calcaterra, Thomas C.

doi:10.1288/00005537-197003000-00012

Cited by 117 publications

(26 citation statements)

References 16 publications

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“…In 1970, Stroud and Calcettera [12] introduced the term “spontaneous perilymph fistula”, based on four patients. A seven-year-old girl, one year after a modified radical mastoidectomy, was laughing and felt “something pop” in the ear accompanied by hearing loss, tinnitus, and nausea.…”

Section: Origin Of the Plf Conceptmentioning

confidence: 99%

Perilymph Fistula: Fifty Years of Controversy

Hornibrook

2012

ISRN Otolaryngology

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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.

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Section: Origin Of the Plf Conceptmentioning

confidence: 99%

Perilymph Fistula: Fifty Years of Controversy

Hornibrook

2012

ISRN Otolaryngology

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“…In individual cases of pancochlear hearing loss a perilymph fistula (PLF) may play an etiological role. A PLF can be caused by external or internal factors (e.g., head injury, scuba diving, lifting) which lead to a relative change in ambient, middle ear, or intracranial pressure, or it can occur spontaneously [16–18]. Patients with PLF mostly present with hearing loss, vertigo, tinnitus and subjective and/or objective fistula symptoms (e.g.…”

Section: Introductionmentioning

confidence: 99%

Predictors of hearing recovery in patients with severe sudden sensorineural hearing loss

Weiß

Böcker

Koopmann³

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundSudden sensorineural hearing loss (SSHL) is a disease, which severely affects the patient’s social and relational life. The underlying pathomechanisms have not been finally clarified yet and outcome is not predictable.MethodsWe conducted a retrospective study in order to identify parameters that influence hearing recovery. The data base contains results of basic otoneurological tests and clinical parameters of 198 patients with idiopathic SSHL of at least 60 dB in at least four frequencies, diagnosed and treated at the University Hospital of Münster, Germany, between 1999 and 2015. Hearing recovery was measured by pure tone audiometry.ResultsMultivariate linear and logistic regression analyses indicate that the chance as well as the magnitude of hearing recovery is higher for patients with normal caloric testing than for patients with pathological caloric testing. However, for the subgroup of patients who attained a hearing recovery, the caloric testing result was not found to influence the magnitude. Instead, the magnitude was noticeably lower for patients within this subgroup who had a previous hearing loss. Furthermore, we found indications that the magnitude is higher for men than for women and that receiving a high-dose steroid therapy is associated with a higher chance and magnitude of a hearing recovery.ConclusionsWe conclude that SSHL associated with disorders of the vestibular system or previous hearing loss represent special sub-entities of SSHL that may be caused by unique pathophysiological mechanisms and are associated with worse outcome. Furthermore, our data support the importance of elevated dosage of steroids in SSHL therapy.

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“…[16][17][18][19] In 1970 Stroud and Calcaterra reported spontaneous leakage and in 1971, Goodhill stressed the point of a relationship between sudden hearing loss and round window rupture. 20,21 Controversy prevails regarding the accuracy of the clinical diagnosis of PLF and many studies have attempted to achieve a better diagnosis of this entity. [22][23][24][25] The diagnosis of PLF is based on a careful subjective evaluation of vestibular function tests, and the intraoperative visualization of the flow of perilymph from the oval and/or round windows at the time of an exploratory tympanotomy.…”

Section: Perilymph Fistulamentioning

confidence: 99%

A Third Labyrinthine Window: An Overview of Perilymph and Labyrinthine Fistulae and Superior Semicircular Canal Dehiscence

2012

An International Journal of Otorhinolaryngology Clinics

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The membranous labyrinth is contained within the bony labyrinth and surrounded by perilymph. The only two 'potentially yielding' parts of the otherwise solid bony labyrinth are the oval and round windows, which by their relative movements, pressure differentials and resilience are responsible for all the functions attributed to the inner ear. In pathologies, such as trauma, infection or occasionally congenital dehiscence, there may develop a 'third window' that may serve as an abnormal communication for the inner ear fluids and manifest with audiovestibular symptoms. Three such distinct entities have been identified, namely 'superior semicircular canal dehiscence syndrome, perilymphatic fistulae and labyrinthine fistulae'. This overview intends to discuss these above-mentioned entities, as regards their characteristic presentations and principles of management.

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Spontaneous perilymph fistulas

Cited by 117 publications

References 16 publications

Perilymph Fistula: Fifty Years of Controversy

Perilymph Fistula: Fifty Years of Controversy

Predictors of hearing recovery in patients with severe sudden sensorineural hearing loss

A Third Labyrinthine Window: An Overview of Perilymph and Labyrinthine Fistulae and Superior Semicircular Canal Dehiscence

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