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Published on: May 23, 2021
[Traumatic perilymphatic fistulae : about 13 cases]
Nadia Kaffel1, Noura Jlassi, Zied Selmi
1Hopital Charles Nicolle, Tunis, Tunisie.
La Tunisie Medicale
|May 11, 2011
Summary
Diagnosing post-traumatic perilymphatic fistulae (PLF) is challenging, often requiring surgery for confirmation. While clinical signs and trauma history are suggestive, surgical outcomes for vertigo showed improvement, but hearing loss recovery was limited.
Area of Science:
- Otolaryngology
- Neurosurgery
- Trauma Surgery
Context:
- Post-traumatic peri-lymphatic fistulae (PLF) arise from ear and temporal bone injuries, often linked to temporal bone fractures.
- Symptoms of PLF are diverse and can be misleading, complicating diagnosis.
- Current indications for exploratory surgery in trauma-related PLF cases are not well-defined.
Purpose:
- To evaluate the key clinical and radiological indicators of post-traumatic perilymphatic fistulae.
- To analyze the diagnostic challenges and treatment outcomes for patients with PLF.
Summary:
- This study examined 13 patients with post-traumatic PLF, noting vertigo (10 patients) and otoliquorrhea (2 patients) as common symptoms.
- Neurosensory hearing loss was prevalent (9 patients), with 5 experiencing complete deafness.
- CT scans identified fractures in 91% of cases and pneumolabyrinth in 4 cases.
- All patients received medical/postural treatment, followed by surgery. Surgical interventions included ear exclusion (1 case) and filling-up (12 cases).
- Post-surgery, vertigo improved in 10 patients, while hearing loss improved in only 2.
Impact:
- Highlights the diagnostic difficulties associated with perilymphatic fistulae, emphasizing the need for surgical confirmation.
- Suggests that while surgery can alleviate vertigo, significant improvements in hearing loss are less common.
- Underscores the ongoing debate regarding surgical indications and optimal timing for post-traumatic PLF management.
