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Acta Otolaryngol. 2017 Jan;137(1):16-22. Epub 2016 Aug 26.

Diagnostic criteria of barotraumatic perilymph fistula based on clinical manifestations.

Author information

1
a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.

Abstract

CONCLUSIONS:

Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF.

OBJECTIVES:

The aim of this study was to establish diagnostic criteria for barotraumatic PLF.

METHODS:

Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF. The causes of barotrauma and clinical symptoms were analyzed by surgical findings. Diagnostic criteria of PLF were proposed according to its clinical manifestations.

RESULTS:

Definite PLF (17 subjects) was confirmed by any evidence of perilymph leak through oval and round windows. For the other seven subjects (probable PLF), even though there was no evidence of perilymph leak, their clinical manifestations were similar to definite PLF. High frequency hearing loss occurred as an early symptom after barotrauma. Positional dizziness occurred a few hours after auditory symptoms (67%). Positional nystagmus was observed in 10 cases. The characteristics of positional nystagmus were multi-directional, longer in duration, smaller in amplitude, no reversibility, and no response to repositioning maneuver. Regarding the surgical outcomes, hearing was significantly improved in the early repaired PFL group, and dizziness was improved in 96% of patients.

KEYWORDS:

Barotrauma; perilymph fistula; positional nystagmus; sudden sensorineural hearing loss

PMID:
27564530
DOI:
10.1080/00016489.2016.1213419
[Indexed for MEDLINE]

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