Definition:
Perilymph fistula, or PLF, is an abnormal opening in the fluid-filled inner ear. Possible places where PLF can occur are: between the middle ear/mastoid sinus, the intracranial cavity, other spaces in the temporal bone, or the bone of the ear called the otic capsule. In most cases it is a tear in thin membranes called oval window and round window, between the middle and inner ears. Perilymph fistula is generally considered a rare disorder and may occur in one or both ears.
Diagnosis:
Several tests are available to check for perilymph fistula ranging from pressure test like the fistula test and positive pressure or Valsalva test, to florescence endoscopy. Audiometry and ENG tests are used to find out which ear is defective.
Although MRI and CT scans are not the best tests for PLF, it can detect other confounding problems.
Treatment:
Treatment depends on where the opening is. Conservatively, restricted movement or bed rest to allow the fistula to heal. In severe cases, surgery may be required to close the opening.
Symptoms and Signs:
Persons suffering from PLF may experience some dizziness, vertigo, imbalance, nausea, and vomiting. Some experience ringing or fullness in the ears and hearing loss. Some symptoms worsen with sudden movement or activity.
Causes:
Head trauma, involving a direct blow to the head, is the most common cause of PLF.
It may also develop from rapid or profound changes in intracranial or atmospheric pressure. Ear surgery is another possible cause. PLF can also be inborn or caused by chronic ear infection.
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