Perilymphatic Fistula - Medtick
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Perilymphatic Fistula

What is it?

Perilymphatic fistula is a tear or defect in the membranes that separate your middle ear and inner ear.

  • Your middle ear is filled with air, while your inner ear is filled with fluid (perilymph).
  • These two areas inside of your ear are separated by membranes.
  • If the membranes rupture, then perilymphatic fluid can flow from your inner ear into your middle ear.
  • The resulting pressure changes can cause balance and hearing problems.
  • In most cases it affects one ear, it rare that it affects both.

Cleveland Clinic

Diagnosis Tests

  • Hearing tests
  • Balance tests
  • Electrocochleography, a test that measures the fluid pressure inside of your inner ear
  • A perilymphatic fistula test, which tracks your eye movements while pressure is applied to your ear canal.
  • Imaging tests to confirm your diagnosis. Perilymphatic fistula radiology tests may include:
    • A CT scan, which produces a 3D X-ray image of the structures inside of your body.
    • MRI, which captures images inside of your body using powerful magnets and radio waves.

Cleveland Clinic

Cause

  • Can be of unknown cause
  • Head trauma , head injury including whiplash
  • Blowing your nose extremely hard
  • A punctured eardrum
  • Exposure to loud noises that are close to your ear, such as gunfire
  • Frequent ear infections
  • Ear trauma
  • Barotrauma (rapid changes in pressure due to flying, scuba diving, heavy lifting and childbirth)

Symptoms

  • Sudden hearing loss?
  • Hearing loss that comes and goes?
  • A feeling of fullness in the ear?
  • Vertigo?
  • Motion sickness and/or nausea?
  • Balance and dizziness problems?
  • Dizziness especially when tilting the head to the affected side?
  • Headache which is on and off or a constant headache longer than 24 hours?
  • Tinnitus (ringing in your ears)?
  • Memory loss?
  • Symptoms worsen when laugh, sneeze or cough?
  • Increase in symptoms when lifting something heavy or changing altitudes?

Complications /Information to beware of/General tips:

Treatment

Bed rest

  • Restricted activity is often the first line of treatment for perilymphatic fistulas.
  • Your healthcare provider may recommend bed rest for one to two weeks.
  • If improvement is noted, then further rest will be recommended until the issue is resolved.

Blood patch injections

  • During this procedure, your healthcare provider injects your own blood into your middle ear. This helps regenerate the damaged membrane.
  • Blood patch injections are somewhat new, and experts are still researching the treatment. So far, the results are encouraging.
  • Full recovery is normally after one month

Surgery

  • If conservative treatments don’t work, then your healthcare provider may recommend surgery.
  • During this procedure, your eardrum is gently lifted and tissue grafts are placed over the damaged membranes between your middle and inner ear.
  • Surgery isn’t right for everyone, so be sure to talk to your healthcare provider about the risks and limitations of this treatment.
  • The procedure generally takes between 30 and 60 minutes.
  • Your eardrum will be lifted through your ear canal so tissue grafts can be placed over the membranes between your inner and middle ear.
    • Dizziness often improves after surgery, but some research suggests hearing loss may not improve, even with surgery.
    • After surgery, it’s important to limit your activity for three days and for the next several weeks to a month, one will need to:
    • Avoid lifting more than 10 pounds
    • Avoid activities that could cause strain, including diving and lifting weights
    • Sleep with your head elevated
    • It’s important to follow all of your healthcare providers’ recommendations after surgery.
    • The recovery period may seem long, but straining the fistula before it fully heals can lead to a persistent fistula.

This condition may show similar symptoms to:

  • Meniere’s disease
  • Vestibular neuritis- hot and red and swelling of parts of the ear that help with balance normally caused by an infection.
  • Labyrinthitis- a condition where one of the vestibular nerves in the ear becomes inflamed.

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Perilymphatic Fistula in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

Diet, Exercise and Body Manipulations

https://my.clevelandclinic.org

https://www.healthline.com

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