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CT cisternography in congenital perilymphatic fistula of the inner ear
K O Lövblad1, C Ozdoba, S Negri
1Department of Neuroradiology, IDR, Inselspital, University of Bern, Switzerland.
Insights
A rare inner ear perilymphatic fistula caused otorrhea in a 5-month-old. Surgical repair involved closing a stapes malformation and associated fluid leak.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neuroscience
Background:
- Perilymphatic fistulas are abnormal leaks of inner ear fluid into the middle ear, a rare cause of otorrhea.
- This case highlights a congenital malformation leading to a perilymphatic fistula in an infant.
Observation:
- A 5-month-old infant presented with sudden onset otorrhea.
- High-resolution CT cisternography revealed a middle ear malformation and cerebrospinal fluid (CSF) leakage into the tympanic cavity via the left oval window.
Findings:
- Surgical exploration confirmed a tympanic membrane tear and a malformed stapes with absent crura.
- A perilymphatic fistula was identified through a defect in the stapes footplate.
Implications:
- This case underscores the importance of considering congenital anomalies in pediatric otorrhea.
- Successful surgical closure of the perilymphatic fistula using local tissue highlights a viable treatment approach.
Abstract:
Perilymphatic fistulas of the inner ear constitute abnormal leaks of perilymphatic fluid into the middle ear or mastoid air cell system and represent a rare cause of otorrhea. We report the case of a 5-month-old child presenting with sudden otorrhea. High resolution CT cisternography showed a malformation of the middle ear and a passage of contrast-enhanced CSF into the tympanic cavity through the left oval window. Surgery confirmed a tear of the tympanic membrane as well as a stapes malformation with aplasia of the crura and an associated perilymphatic fistula through a defect in the stapes footplate. The fistula was closed with adipose tissue from the ear lobe.