Rupture of the round window membrane

Tonkin, John; Fagan, Paul

doi:10.1017/s0022215100080944

Cited by 51 publications

(12 citation statements)

References 7 publications

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“…His theory stimulated an interest in possible round window ruptures from either of these mechanisms. In 1975, Tonkin and Fagan [24] reported on thirteen patients with a round window fistula where the initiating event appeared to be direct head trauma in four, but exertion, barotrauma from flying and diving, acoustic trauma, vomiting, and postoperative in the remainder. They stressed that the incident could be long forgotten by the patient.…”

Section: Mechanisms Of Plfmentioning

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: Mechanisms Of Plfmentioning

confidence: 99%

Perilymph Fistula: Fifty Years of Controversy

Hornibrook

2012

ISRN Otolaryngology

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“…This should be done as quickly as possible, but as some fistulas heal sponta neously, treatment may be deferred for some days, depending on the severity of the symp toms and the degree of improvement. The observation time varies in diflerent reports but does not in general exceed 5-7 days [1,4], Owing to the risk of meningitis, perma nent fistulas should be closed even in pa tients whose hearing must be considered to tally lost [9], In general, vertigo responds sat isfactorily to closure of the fistula, whereas the results regarding hearing and tinnitus are more dubious [3],…”

Section: Discussionmentioning

confidence: 99%

Perilymph Fistulas Caused by Myringotomy

Jensen¹

1986

ORL

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Two cases of rupture of the round window membrane verified by operation are presented. Both cases arose in connection with myringotomy and were presumably caused by a violent force acting directly on the tympanic membrane and the ossicles. This would result in a strong movement of the stapes and an acute change in the perilymph pressure, thereby causing an indirect injury to the round window. Symptoms and treatment are briefly discussed.

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“…In the second case, there is considerable increase or intratympanic and auditory tube pressure 38 . The implosive force could create a rupture of the cochlear membrane and perilymphatic fistula in patients submitted to general anesthesia with the gas 39,40 . Thus, oval window rupture by implosive mechanism could occur in the anesthetic induction by a sudden movement of the TM, and consequently, a stapedial movement 37 .…”

Section: Immittanciometrymentioning

confidence: 99%

Avaliação de alterações timpanométricas em pacientes submetidos à anestesia geral com óxido nitroso

Teixeira¹,

Tomita

Lima

2005

Rev. Bras. Otorrinolaringol.

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Ni trous oxide is an inhaling gas that can increase intratympanic pressure during the anesthetic act and cause negative pressure after it is discontinued, mainly in patients with Eustachian tube dysfunction. These pressure variations may come up with clinical implications such as tympanic membrane rupture, ossicular system disarticulation, haemotympanum, barotraumas, prosthesis displacement stapaedotomy and tympanic graft lateralization after tympanoplasty, in addition to serous fluid entrance into the middle ear during the negative pressure phase. Aim: To evaluate the nitrous oxide influence on the middle ear pressure in a population without tube malfunction performing pre and postoperative tympanometry. Study design: Transversal cohort. Material and Method: A prospective study was carried out with Universitário Clementino Fraga Filho Hospital-UFRJ inpatients submitted to general anesthesia with the use of 50% nitrous oxide from April to June 2003. It was also evaluated whether the duration of surgery, associated anesthetics, presence of allergic rhinitis and nasal septal deviation could contribute to the onset of intratympanic pressure alteration. Results: The sample was made up of 50 patients and in almost half of them (48%), postoperative tympanometry alterations (type C curve) were found when comparing to preoperative tympanometric control (type A curve). Neither gender nor age interfered in the onset of postoperative tympanometry alterations, similarly to surgery duration. The associated volatile anesthetic type, nasal septal deviation and allergic rhinitis were not able to influence postoperative middle ear pressure. Conclusion: Nitrous oxide modifies intratympanic pressure during the anesthetic act and after its discontinuation.Palavras-chave: óxido nitroso, pressão intratimpânica, alterações timpanométricas.

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Rupture of the round window membrane

Cited by 51 publications

References 7 publications

Perilymph Fistula: Fifty Years of Controversy

Perilymph Fistula: Fifty Years of Controversy

Perilymph Fistulas Caused by Myringotomy

Avaliação de alterações timpanométricas em pacientes submetidos à anestesia geral com óxido nitroso

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