Hydrops following perilymph fistula repair

Potter, Charles R.; Conner, George H.

doi:10.1288/00005537-198306000-00022

Cited by 24 publications

(5 citation statements)

References 7 publications

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“…The cause of MD is still unknown, but it has one defining pathological feature: endolymphatic hydrops (85,86). MD and PLF have been found in close association (87,88), and PLF-induced changes in perilymph flows may alter the fluid production and balance in the inner ear so as to result in endolymphatic hydrops in some cases (89). Therefore, endolymphatic hydrops may be seen in both MD and PLF, and many patients with a PLF may have an element of MD as well.…”

Section: Discussion Of Other Potential Causes and Associations Of Idimentioning

confidence: 99%

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

et al. 2020

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A perilymphatic fistula (PLF) is an abnormal communication between the perilymph-filled inner ear and the middle ear cavity, mastoid, or intracranial cavity. A PLF most commonly forms when the integrity of the oval or round window is compromised, and it may be trauma-induced or may occur with no known cause (idiopathic). Controversy regarding the diagnosis of idiopathic PLF has persisted for decades, and the presenting symptoms may be vague. However, potential exists for this condition to be one of the few etiologies of dizziness, tinnitus, and hearing loss that can be treated surgically. The aim of this review is to provide an update on classification, diagnosis, and treatment of PLF. Particular attention will be paid to idiopathic PLF and conditions that may have a similar presentation, with subsequent information on how best to distinguish them. Novel diagnostic criteria for PLF and management strategy for PLF and PLF-like symptoms is presented.

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Section: Discussion Of Other Potential Causes and Associations Of Idimentioning

confidence: 99%

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

et al. 2020

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“…Sometimes, vestibular symptoms occur with fluctuating or progressive hearing loss, and as in this case, they are differentiated from MD. Therefore, in previous reports, MD and PLF were closely related, and PLF is thought to be complicated by endolymphatic hydrops, similar to MD ( 3 , 7 – 9 ). Cerebrospinal fluid (CSF) fistula is a vestibular disorder that involves fistula as well as PLF.…”

Section: Discussionmentioning

confidence: 92%

Perilymphatic fistula with characteristic findings of the inner ear by contrast-enhanced magnetic resonance imaging: a case report

Ito,

Seo,

Sasano

et al. 2023

Front. Neurol.

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A perilymphatic fistula (PLF) presents with abnormal traffic in the otic capsule, causing cochlear and vestibular symptoms. However, the mechanisms underlying symptom recurrence remain controversial. Herein, we report the case of a 27-year-old female who complained of hearing disturbance in her right ear and recurrent vertigo after sudden onset of hearing loss with vertigo. The caloric test revealed unilateral weakness in the right ear, and the video head impulse test (vHIT) showed decreased vestibulo-ocular reflex (VOR) gain. Contrast-enhanced magnetic resonance imaging (MRI) using hybrid of reversed image of positive endolymph signal and negative image of perilymph signal (HYDROPS) indicated a collapsed endolymphatic space. As the vestibular symptoms did not improve, an exploratory tympanotomy was performed on the right ear. Although perilymph leakage was not noted in the oval or round windows, both windows were sealed with connective tissue. The patient's vestibular symptoms rapidly improved after surgery, and postoperative contrast-enhanced MRI showed improvement in the collapsed endolymphatic space. Although the caloric test revealed unilateral weakness, the VOR gain on the vHIT improved to normal on the right side. Thus, these findings indicated that recurrent symptoms caused by PLF are associated with a collapsed endolymphatic space. We speculate that the collapsed endolymphatic space was due to a ruptured Reissner's membrane. We hypothesized that sealing the fistula would promote normalization of perilymph pressure. The ruptured Reissner's membrane may have been gradually repaired as vestibular symptoms improved. This case adds to the existing literature on the occurrence of the “double-membrane break syndrome”. Collapse of the endolymph due to a ruptured Reissner's membrane may be the cause of PLF symptoms.

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“…In one case at two re-explorations the fascia graft was found to have totally disappeared. Other material, such as fat, vein graft, perichondrium, and subcutaneous areolar tissue, have been used by many authors but usually with a rather high rate of recurrence (Thompson and Kohut, 1979;Potter and Conner, 1983;Seltzer and McCabe, 1986;Muntarbhom and Webber, 1987). Probably careful elevation of the mucosa around the fistula site prior to graft insertion is the most important step in this operation.…”

Section: Discussionmentioning

confidence: 99%

Perilymph fistula—a diagnostic dilemma

et al. 1991

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A retrospective series is presented of 51 cases operated on for suspected perilymph fistula. In 26 ears a fistula was identified at surgery. A positive fistula test was found to strongly indicate a perilymph fistula but was more often negative than positive in surgically demonstrated fistula ears. Other vestibular tests were found to be of little value in the pre-operative diagnosis. Ears with a surgically demonstrated fistula and sensorineural hearing loss had either flat or downward-sloping audiograms. Difficulties in diagnosing a perilymph fistula at tympanotomy are discussed. At follow-up, vestibular symptoms were found to be eliminated or improved in 96 per cent of cases with surgically demonstrated fistulae and in 68 per cent of cases in which no fistula was detected at tympanotomy but hearing improved significantly in only one ear (4 per cent) of the former group and in five ears (20 per cent) of the latter group.

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Hydrops following perilymph fistula repair

Cited by 24 publications

References 7 publications

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

Perilymphatic fistula with characteristic findings of the inner ear by contrast-enhanced magnetic resonance imaging: a case report

Perilymph fistula—a diagnostic dilemma

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