Perilymphatic fistula of the round window - 22/06/11

Doi : 10.1016/j.anorl.2010.12.004

M. Al Felasi ^a, G. Pierre ^a, M. Mondain ^a,^b, A. Uziel ^a,^b, F. Venail ^a,^⁎,^b
^a Service ORL et centre d’implantation cochléaire, CHU Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
^b Inserm U583, physiopathologie des déficits sensoriels et moteurs, institut des neurosciences de Montpellier, hôpital Saint-Eloi, bâtiment INM, 80, rue Augustin-Fliche, BP 74103, 34091 Montpellier cedex 5, France

Corresponding author. Tel.: +33 4 67 33 68 00.

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Summary

Objective

To highlight diagnostic and treatment pitfalls in perilymphatic fistula.

Case reports

Two cases of round-window fistula are reported, detailing clinical aspect, treatment and outcome. The triad comprising sensorineural hearing loss, tinnitus and vertigo with associated fistula sign is classical but in fact rarely encountered. Imaging is of limited contribution, but may reveal anatomic abnormalities suggestive of perilymphatic fistula. Outcome is improved by early management, especially in case of moderate hearing loss.

Discussion/conclusion

Diagnosis of perilymphatic fistula is challenging, but enables effective treatment. On any suspicion, surgical exploration should be undertaken, being the only reliable guide to diagnosis and etiologically adapted management.

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Keywords : Perilymphatic fistula, Fistula sign, Round window