Perilymph Fistula

  What is it?

  A perilymph fistula (PLF) is
  an abnormal opening
  between the air-filled
  middle ear and the fluid-
  filled inner ear. In most
  instances it is a tear or
  defect in one or both
  of the small, thin membranes
  between the middle and
  inner ears. These
  membranes are called the
  "oval window" and the
  "round window".

  Another possible location for
  a fistula is in the bone of
  the ear (the otic capsule).
  This is a rare condition
  where the bone between
  the ear and brain area is missing or thin, causing symptoms very similar to that of a
  round or oval window fistula. The most common type is located just above the superior
  semicircular canal and is called the superior canal dehiscence syndrome.

  What are the symptoms?

• Dizziness
• Vertigo
• Imbalance
• Hearing symptoms (tinnitus - ringing in the ears, hearing loss)
• Pressure sensitivity
• Tullio's phenomenon (sensitivity to loud noises)

  What causes it?

• Head trauma is the most common cause (usually involving a direct blow to the ear)
• Rapid or profound changes in intracranial or atmospheric pressure (e.g., scuba diving)
• Congenital
• Chronic ear infections
• Ear surgery

  How is it treated?

  In many cases, a fistula will heal itself if activity is markedly restricted. In such
  cases, strict bed rest may be recommended to give the fistula a chance to close. If
  symptoms are severe and have not responded to conservative treatment (bed rest), or
  there is progressive hearing loss, surgical repair of the fistulas may be required.
  This procedure involves placing a graft over the fistual defect in the oval and/or
  round window.

  People with fistulas should avoid lifting, straining or bending over, or any activity
  that would increase the pressure in the head, as all of these will make symptoms
  worse and prevent the fistual from healing. Air pressure changes (using elevators,
  traveling in the mountains or flying in airplanes) should also be avoided as these
  changes will tend to make your symptoms worse.

  Balance Retraining Therapy is a specialized form of physical therapy which addresses
  the effects (e.g., dizziness, vertigo and unsteadiness) of fistulas once the tear is
  stabilized.

  Click here to download a PDF version of this page: