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|Year : 2016 | Volume
| Issue : 6 | Page : 1383-1384
Perilymph fistula of oval window presenting as otogenic dizziness
Department of Radiodiagnosis, Sree Balaji, Medical College and Hospital, Chennai, Tamil Nadu, India
|Date of Web Publication||11-Nov-2016|
Dr. Venkatraman Indiran
Department of Radiodiagnosis, Sree Balaji, Medical College and Hospital, Chromepet, Chennai - 600 044, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Indiran V. Perilymph fistula of oval window presenting as otogenic dizziness. Neurol India 2016;64:1383-4
A 58-year-old female patient presented with left-sided hearing loss for 2 years, tinnitus for 6 months, and giddiness for 1 month. The patient had a history of ear surgery at 12 years of age, the details of which were not known. The fistula test, which records eye movements while pressurizing each ear canal with a small rubber bulb, produced only slight nystagmus. Audiometry showed sensorineural hearing loss. High-resolution computed tomography (HRCT) of the temporal bone revealed a small bony defect in the region of left oval window, with extension of stapes foot plate into the left vestibule [[Figure 1], Video 1], prompting the diagnosis of a perilymph fistula. The patient was advised a trial of bed rest along with the prescription of 16 mg betahistine for 2 weeks. Perilymph fistula, an abnormal communication between perilymph space and middle ear, may be either congenital or acquired. It is one of the causes of otogenic dizziness. The most common sites of the fistula are the oval window and round window. Other sites include the semicircular canals and the otic capsule. The acquired fistula may be iatrogenic, traumatic, or erosive. Trauma from head injury, flying and diving barotrauma, sneezing, coughing, and labour are the most common causes of perilymphatic fistula. Symptoms may include vertigo, imbalance, tinnitus, hearing loss, nausea, and vomiting. Symptoms may worsen with coughing, sneezing, and with exertion and activity. HRCT of the temporal bone is better at depicting the bony abnormalities than magnetic resonance imaging (MRI). Conservative treatment such as bed rest, betahistine, and mild sedatives may be attempted. The definitive treatment is the surgical placement of a graft to obliterate the fistula.,,
|Figure 1: High-resolution computed tomography of the temporal bone (a and c) revealed normal appearance of the stapes at the oval window on the right side. (b and d) A small bony defect in the region of the oval window on the left side with extension of the foot plate of stapes across the bony defect into the left vestibule|
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| » References|| |
Roman S, Bourliere-Najean B, Triglia JM. Congenital and acquired perilymph fistula: Review of the literature. Acta Otorhinolaryngol Ital 1998;18(4 Suppl 59):28-32.
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