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Large perilymph fistulas.

M Luntz, I Frank, I Yurovitzki

    The American Journal of Otology
    |July 1, 1986
    PubMed
    Summary
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    Large perilymph fistulas can cause recurrent meningitis. Surgical obliteration of the vestibule, not just fistula closure, is recommended for effective prevention.

    Area of Science:

    • Otolaryngology
    • Neurology
    • Pediatrics

    Background:

    • Perilymph fistulas (PLFs) can present with otologic or neurologic symptoms.
    • Large PLFs are often associated with significant neurologic manifestations.

    Observation:

    • A case of a 3-year-old girl with recurrent bacterial meningitis was investigated.
    • The patient exhibited a large perilymph fistula with a right undeveloped cochlea and labyrinth.
    • Multiple defects were noted in the medial wall of her middle ear.

    Findings:

    • Recurrent meningitis in this case was linked to a large congenital perilymph fistula.
    • Simple fistula closure was deemed insufficient for preventing recurrent meningitis.
    • Surgical obliteration of a deeper structure, specifically the vestibule, was identified as the preferred method.

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    Implications:

    • This case highlights the critical link between large PLFs and recurrent meningitis.
    • Effective management of large congenital PLFs requires more than simple fistula repair.
    • Vestibular obliteration is proposed as the surgical method of choice for preventing recurrent meningitis in such cases.