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Case report: Perilymphatic fistula from a round window microfissure.
Toru Seo1, Arata Kemmochi1, Yosuke Koike1
1Department of Otolaryngology, Yokohama Seibu Hospital, St. Marianna University School of Medicine, Yokohama, Japan.
Frontiers in Neurology
|October 16, 2023
Summary
A rare microfissure near the round window niche can cause hearing loss and vertigo. Surgical sealing of this microfissure led to significant improvement in a patient's hearing and balance.
Area of Science:
- Otolaryngology
- Neuroscience
- Anatomy
Background:
- A microfissure near the round window niche is an anatomical communication between the middle ear and the posterior semicircular canal.
- The clinical etiology of inner ear symptoms attributed to such microfissures remains unconfirmed.
Observation:
- A 50-year-old male presented with hearing disturbance, tinnitus, and vertigo.
- The patient exhibited moderate sensorineural hearing loss and worsening vertigo, suggestive of inner ear pathology.
- Exploratory tympanotomy revealed a microfissure and fluid accumulation in the round window niche.
Findings:
- Surgical packing of the microfissure with connective tissue was performed.
- Postoperatively, the patient experienced significant improvement in hearing and a reduction in vertigo.
- Hearing improved from 43.3 dB to 20.0 dB, and disequilibrium resolved.
Implications:
- This case suggests a potential clinical link between microfissures near the round window niche and inner ear symptoms.
- Surgical intervention, specifically sealing the microfissure, may effectively treat associated hearing loss and vertigo.
- Further clinical investigation is warranted to confirm the role of these microfissures in audiovestibular disorders.
