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Published on: May 26, 2023
[Diagnosis and treatment of post-traumatic perilymphatic fistula: Report of 16 cases]
J B Morvan1, O Cathelinaud, D Rivière
1Hôpital d'Instruction des Armées Sainte Anne, Service ORL et CCF, 83000 Toulon, France. jbmorvan@hotmail.com
Introduction:
When facing cochleovestibular symptoms such as hearing loss, dizziness or unsteadiness, or a tinnitus evolving in the aftermath of a cranial trauma or overpressure in the form of inner ear barotrauma after diving or a from blast, a perilymphatic fistula must be considered.
Materials And Methods:
We present a homogenous prospective series of 16 cases of perilymphatic fistulae occurring after head trauma or overpressure between 2003 and 2011. Patients suspected of suffering from a perilymphatic fistula and presenting with the following criteria were included: the occurrence after a variable delay of cochleovestibular symptoms (vertigo, tinnitus, and hearing loss) in the aftermath of a head trauma or overpressure. All patients received medical treatment with intravenous corticosteroids. Failure of the initial treatment and in the presence of clinical data suggesting a perilymphatic fistula, an exploration of the middle ear was performed.
Results:
13 patients (81.2% underwent surgical exploration with early and stable subtotal recovery of hearing in 90%, a rapid disappearance of vertigo in 89.9%, a loss of tinnitus in 45% and in 27% improvement.
Conclusion:
The diagnosis must be supported by various diagnostic tests. If evidence in favor of a perilymphatic fistula is credible, surgery has always achieved an excellent functional outcome.
