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Perilymph fistula resulting from microfissures
D B Kamerer1, I Sando, B Hirsch
1Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye and Ear Hospital, PA 15213.
Abstract:
Perilymphatic fistulas are well documented in the otolaryngologic literature as a cause for both auditory and vestibular symptoms. The anatomic location of fistulas has been clinically confirmed in both the oval and round windows. Furthermore, membranous tears within the cochlea have been described post mortem and may be the cause of the remaining fistulas which are suspected but not confirmed surgically. A fourth source of perilymph fistula has previously been suggested by Okano and Harada. During the past several years, surgical confirmation of perilymph leakage from two microfissure areas has been observed. These cases will be briefly discussed along with their clinical implications. Speculation as to the type of hearing loss caused by fistulas will be offered. Hypotheses concerning the various symptoms encountered in patients and the location of the defect will also be addressed.
Insights
Perilymphatic fistulas, often causing hearing and balance issues, can arise from various cochlear locations. Surgical confirmation of leakage from previously unknown microfissure areas offers new insights into these conditions.
Area of Science:
- Otolaryngology
- Neuroscience
Background:
- Perilymphatic fistulas are recognized causes of auditory and vestibular dysfunction.
- Clinically confirmed fistula locations include the oval and round windows.
Observation:
- Membranous cochlear tears are described postmortem, suspected as a cause for some fistulas.
- A fourth potential source of perilymph fistula was previously hypothesized.
- Recent surgical findings confirm perilymph leakage from two novel microfissure areas.
Findings:
- Surgical confirmation of perilymph leakage from two previously undescribed microfissure sites.
- Discussion of clinical implications associated with these newly identified fistula sources.
Implications:
- Understanding these new fistula locations may refine diagnosis and treatment of hearing loss and vestibular symptoms.
- Further research into the etiology and specific symptoms related to these microfissures is warranted.