1/9. A case of barotrauma-induced pneumolabyrinth secondary to perilymphatic fistula.We report the case of a 62-year-old woman who experienced pneumolabyrinth associated with a perilymphatic fistula. Her condition was diagnosed with the help of computed tomography, which detected the presence of an air bubble in the labyrinth, and middle ear exploration, which revealed that clear fluid was emanating from the round window niche in a manner consistent with the presence of a perilymphatic fistula. The niche was repaired with tragal perichondrium and bolstered with Gelfoam.- - - - - - - - - - ranking = 1keywords = window (Clic here for more details about this article) |
2/9. Perilymphatic fistula induced by barotrauma.The association between diving, barotrauma, and the production of perilymphatic fistula has been known for almost 20 years. Forty-eight cases of round and oval window fistulas following diving have been reviewed and essentially corroborate previous findings. Any patient with a history of diving and subsequent sensorineural hearing loss within 72 hours should be suspected of having a round or oval window perilymphatic fistula and surgical exploration and closure of the fistula should be undertaken. patients who have a loss of hearing, vertigo, nausea, or vomiting following a decompression dive should be re-compressed and if symptoms do not clear, exploration should be performed. Surgical treatment should be executed as soon as possible after the diagnosis is suspected for the best possible results.- - - - - - - - - - ranking = 2keywords = window (Clic here for more details about this article) |
3/9. Inner ear decompression sickness combined with a fistula of the round window. Case report.Inner ear barotrauma with rupture of the round or oval window secondary to diving and decompression sickness (DCS) of the inner ear can be a difficult diagnosis to differentiate. The dive profile or associated elements of DCS will often confirm the diagnosis. Occasionally, diagnosis is made during recompression or during operation. The differential diagnosis is important, since immediate recompression is indicated for inner ear DCS, while it is contraindicated in cases of inner ear barotrauma. We have found no cases reported in the world literature in which both diseases have been diagnosed and proven simultaneously. We present a case of a diver who developed DCS with inner ear manifestations complicated by a round window fistula. Treatment and clinical outcome are discussed along with a brief review of the suspected cause.- - - - - - - - - - ranking = 6keywords = window (Clic here for more details about this article) |
4/9. Conservative management of inner ear barotrauma resulting from scuba diving.Fourteen patients who experienced inner ear barotrauma (IEBT) while scuba diving were examined shortly after the episode and were followed up until symptoms resolved or stabilized. On the basis of these observations and a review of the literature, three types of IEBT are hypothesized that usually result from forceful autoinflation of the middle ear: (1) hemorrhage within the inner ear, (2) labyrinthine membrane tear, and (3) perilymph fistula through the round or oval window. Presenting symptoms, treatment regimens, and final results are detailed.- - - - - - - - - - ranking = 1keywords = window (Clic here for more details about this article) |
5/9. Suppressed sneezing as a cause of hearing loss and vertigo.Two cases of inner ear injury caused by suppressed sneezing are described. One patient experienced vestibular symptoms in the form of reflexogenic vertigo that was relieved by surgical section of the tensor tympani tendon. The other patient had a sudden severe permanent sensorineural hearing loss. It is proposed that the aerodynamic pressure increase associated with suppressed sneezing is transmitted via the eustachian tube to cause an implosive fistula of either the round or oval window with injury to the membranous labyrinth.- - - - - - - - - - ranking = 1keywords = window (Clic here for more details about this article) |
6/9. Sudden hearing loss in divers and fliers.Many papers have been written about sudden sensory hearing loss and the effect of barotrauma on the inner ear. Fistulae of the round and oval window membranes have been implicated in the great majority of these cases. It has usually been recommended that the patient be treated with conservative therapy, such as bed rest, for a period of as long as 30 days and that the final hearing results are as good or better than those that have been surgically explored and corrected. In our experience immediate surgical exploration and correction of sudden severe or profound sensorineural deafness in the diver or flier is absolutely essential and the excellent results of hearing improvement in this select group certainly corroborates this theory. Other cases with the hearing loss limited to the high frequencies most notably have tinnitus and surgical exploration does not improve the hearing but may improve vertigo if present. Numerous cases are presented to support these supositions.- - - - - - - - - - ranking = 1keywords = window (Clic here for more details about this article) |
7/9. Round window membrane rupture and acquired sensorineural hearing loss in children.The aetiology of acquired sensorineural hearing loss includes many conditions. The disparity between the number of children affected by the conditions which are supposed to cause hearing loss and the number of children who are actually deaf, has never been satisfactorily explained. Clinical features observed in children with surgically proven round window membrane rupture have been noted in all conventional aetiological groups. These features include otitis media, doubt about the hearing status in early life, disturbance of balance and other occasional neurological phenomena. Wide variation in the appearance of round window niche has been observed in children with secretory otitis and similar appearances have been observed in children with proven round window membrane rupture. The appearances may represent a reaction to perilymph. Round window membrane rupture is probably common and may prove to be a unifying factor for many cases of acquired sensorineural hearing loss. Occasional neurological phenomena may be related to it.- - - - - - - - - - ranking = 8keywords = window (Clic here for more details about this article) |
8/9. A case of Tullio phenomenon in a subject with oval window fistula due to barotrauma.The Tullio phenomenon is defined as vertigo that occurs as a result of extremely high acoustic stimuli. Stimulation of the system of semicircular canals and otoliths causes nystagmus, reflex head tilt and body sway, and vertigo to occur. This condition is quite rare. The Tullio phenomenon was diagnosed in a patient with a fistula of the oval window due to barotrauma. It was diagnosed after a careful examination by Frenzel's glasses. The complaints of vertigo disappeared after the fistula had been closed surgically.- - - - - - - - - - ranking = 5keywords = window (Clic here for more details about this article) |
9/9. Spontaneous perilymphatic fistula: electrophysiologic findings in animals and man.The case against the occurrence of spontaneous perilymphatic fistulas is presented. Electrophysiologic findings both in animals and in man suggest that small holes in either the round or oval window are not associated with any significant hearing loss. Removal of perilymph may cause some changes in the electrocochleogram that can be reversed when the perilymph is replaced. Tympanotomy surgery, especially when performed with the injection of local anesthetic solutions may result in transudates in the middle ear that are difficult to differentiate from perilymph leaking out from the inner ear. Perilymphatic fistulas were excluded by performing a posterior myringotomy under general anesthesia in 162 congenitally deaf ears. If fluid was present it was suctioned, and if no change occurred on the intraoperative electrocochleogram, it was concluded that no fistula existed. Based on the electrophysiologic findings and the clinical observations in over 240 ears, it was concluded that spontaneous perilymphatic fistulas do not exist. The author accepts that perilymphatic fistulas occur after surgery, especially after stapedectomy, and that they can occur after head injury or barotrauma. However, these should heal readily; persistent or intermittent fistulas are an otologic rarity.- - - - - - - - - - ranking = 1keywords = window (Clic here for more details about this article) |