This topic provides information about perilymph fistula.
What is perilymph fistula?
A perilymph fistula occurs when there is a hole or tear in the thin membrane of the oval window or round window which separates the inner ear from the middle ear. When this tear occurs, the fluid in the inner ear, called perilymph, leaks into the middle ear space.
What Causes a perilymph fistula?
Perilymph fistula has two main causes:
- The most common causes of a perlymph fistula is trauma to the head or a sudden change in atmospheric presssure, called barotrauma, usually occurring on an airplane or scuba diving.
- A perilymph fistula has been seen as a side effect of syphilis or Lyme disease. In some cases, the cause of a perilymph fistula is unknown.
What are the Symptoms?
The symptoms of a perilymph fistula can include the following:
- Sudden change in hearing in one ear (sudden hearing loss)
- Tinnitus in one ear
- Pressure in the ear
- Dizziness, imbalance or vertigo
Some people with a perilymph fistula will note an increase in dizziness or imbalance immediately following sneezing or blowing their nose. An increase in dizziness may also occur when lifting a heavy object or in response to sound, known as Tullio’s Phenomenon.
How is a perilymph fistula diagnosed?
Symptoms of a perilymph fistula can be very similar to the symptoms of other ear conditions, including Superior Canal Dehiscence (SCD) or Meniere’s Disease. Therefore, diagnosis of a perilymph fistula can be difficult. In some cases, a fistula can be seen on an MRI or CT Scan but not always. The following diagnostic tests may also be used to determine the presence of a perilymph fistula:
- Videonystagmography (VNG) or Electronystagmography (ENG) test, including a fistula screening
- Electrocochleography (ECog)
The tests above are performed by a trained Audiologist.
How is it treated?
With limited physical activity, a perilymph fistula can heal on its own. Strict bed rest is recommended at first diagnosis. If symptoms begin to improve, activity restiction can be recommended for up to six months.
If symptoms do not improve with bed rest, surgical repair using a tissue graft is the next step in treating a perilymph fistula.
Certain medications can be used to treat symptoms of dizziness and nausea, however they will not have any effect on the fistula itself.