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Perilymph fistula: the patients' experience

Published online by Cambridge University Press:  26 April 2016

J A Meldrum  and
P R Prinsley
J A Meldrum*
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, UK
P R Prinsley
Affiliation:
Department of Otolaryngology, James Paget University Hospital, Great Yarmouth, UK Department of Otolaryngology, Norfolk and Norwich University NHS Foundation Trust, Norwich, UK
*
Address for correspondence: Ms J A Meldrum, 36 Marewa Street, Kew, Dunedin 9012, New Zealand E-mail: jmeldrum@doctors.org.uk
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Abstract

Objective:

This study aimed to assess the experiences and outcomes of patients who underwent surgical repair of a perilymph fistula in Norfolk, UK.

Methods:

The study involved a retrospective questionnaire-based patient survey and case note review of patients who had undergone tympanotomy and perilymph fistula repair between 1998 and 2012 in two district general hospitals.

Results:

Fourteen patients underwent 20 procedures, of whom 7 completed the pre- and post-operative Vertigo Symptom Scale. In five patients, there was no obvious precipitating cause. Perilymph fistula was precipitated by noise in one patient, by a pressure-increasing event in six patients and by trauma in two patients. The Vertigo Symptom Scale scores showed a statistically significant improvement following surgical repair, from a median of 67 (out of 175) pre-operatively to 19 post-operatively.

Conclusion:

In selected patients with vertigo, perilymph fistula should be considered; surgical repair can significantly improve symptoms.

Keywords

Perilymphatic DuctFistulaVertigoOutcomes Assessment
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 6 , June 2016 , pp. 526 - 531
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Black, FO, Pesznecker, S, Norton, T, Fowler, L, Lilly, DJ, Shupert, C et al. Surgical management of perilymphatic fistulas: a Portland experience. Am J Otol 1992;13:254–62Google ScholarPubMed
2 Black, FO, Pezsnecker, S, Norton, T, Fowler, L, Lilly, DJ, Shupert, C et al. Surgical management of perilymph fistulas. A new technique. Arch Otolaryngol Head Neck Surg 1991;117:641–8Google Scholar
3 Monsell, EM. New and revised reporting guidelines from the Committee on Hearing and Equilibrium. American Academy of Otolaryngology - Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:176–8CrossRefGoogle Scholar
4 Morris, MS, Kil, J, Carvlin, MJ. Magnetic resonance imaging of perilymphatic fistula. Laryngoscope 1993;103:729–33Google Scholar
5 Davies, RE. Diagnosis and management of perilymph fistula: the University of North Carolina approach. Am J Otol 1992;13:85–9Google Scholar
6 Yardley, L, Masson, E, Verschuur, C, Haacke, N, Luxon, L. Symptoms, anxiety and handicap in dizzy patients: the development of the vertigo symptom scale. J Psychosom Res 1992;36:731–41Google Scholar
7 Hornibrook, J. Perilymph fistula: fifty years of controversy. ISRN Otolaryngol 2012;2012:281248 CrossRefGoogle ScholarPubMed
8 Shea, JJ. The myth of spontaneous perilymph fistula. Otolaryngol Head Neck Surg 1992;107:613–16Google Scholar
9 Minor, LB, Soloman, D, Zinreich, JS, Zee, DS. Sound and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 1998;24:249–58Google Scholar
10 Skedros, DG, Cass, SP, Hirsch, BE, Kelly, RH. Beta-2 transferrin assay in clinical management of cerebral spinal fluid and perilymphatic fluid leaks. J Otolaryngol 1993;22:341–4Google Scholar
11 Buchman, CA, Luxford, WM, Hirsch, BE, Fucci, MJ, Kelly, RH. Beta-2 transferrin assay in the identification of perilymph. Am J Otol 1999;20:174–8Google ScholarPubMed
12 Ikezono, T, Shindo, S, Sekiguchi, S, Morizane, T, Pawankar, R, Watanabe, A et al. The performance of Cochlin-tomoprotein detection test in the diagnosis of perilymphatic fistula. Audiol Neurootol 2010;15:168–74Google Scholar
13 Kohut, RI. Perilymph fistulas. Clinical criteria. Arch Otolaryngol Head Neck Surg 1992;118:687–92Google Scholar
14 Poe, DS, Bottrill, ID. Comparison of endoscopic and surgical explorations for perilymphatic fistulas. Am J Otol 1994;15:735–8Google ScholarPubMed
15 Farrier, JB. Abstruce complications of stapes surgery. In: Schuknecht, H, ed. International Symposium on Otosclerosis. Boston: Little Brown and Co, 1962;509–21Google Scholar
16 Steffen, TN, House, HP, Seeley, JL. The slipped strut problem. A review of 52 cases. Ann Otol Rhinol Laryngol 1963;72:191–205 CrossRefGoogle ScholarPubMed
17 Fee, GA. Traumatic perilymph fistulas. Arch Otolaryngol 1968;88:43–6Google Scholar
18 Stroud, MH, Calceterra, TC. Spontaneous perilymph fistulas. Laryngoscope 1970;80:479–87Google Scholar
19 Seltzer, S, McCabe, BF. Perilymph fistula: Iowa experience. Laryngoscope 1986;96:37–49 CrossRefGoogle ScholarPubMed
20 Rizer, FM, House, JW. Perilymph fistulas: the House Ear Clinic experience. Otolaryngol Head Neck Surg 1991;104:239–43Google Scholar
21 Fitzgerald, DC. Myth of spontaneous perilymph fistula. Otolaryngol Head Neck Surg 1993;109:967 Google Scholar
22 Hughes, GB, Sisimanis, A, House, JW. Is there consensus in perilymph fistula management? Otolaryngol Head Neck Surg 1990;102:111–17CrossRefGoogle ScholarPubMed
23 Healy, GB, Strong, MS, Sampogna, D. Ataxia, vertigo, and hearing loss. A result of rupture of inner ear window. Arch Otolaryngol 1974;100:130–5CrossRefGoogle ScholarPubMed
24 Black, FO, Lilly, DJ, Nashner, LM, Peterka, RJ, Pesznecker, SC. Quantitative diagnostic test for perilymph fistulas. Otolaryngol Head Neck Surg 1987;96:125–34Google Scholar
25 Shelton, C, Simmons, FB. Perilymph fistula: the Stanford experience. Ann Otol Rhinol Laryngol 1988;97:105–8Google Scholar
26 Smith, WK, Sandooram, D, Prinsley, PR. Intratympanic gentamicin treatment in Meniere's disease: patients’ experiences and outcomes. J Laryngol Otol 2006;120:730–5Google Scholar
27 Buchanan, MA, Rai, A, Prinsley, PR. Initial UK experience of patient satisfaction with the Meniett® device for Ménière's disease treatment. J Laryngol Otol 2010;124:1067–72Google Scholar
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