Perilymph Fistula is a tear in one of the membranes that separate your middle & inner ear. To understand the condition in a better way, we have to understand the anatomy of the ear. The middle ear is filled with air, & the inner ear is filled with a fluid called perilymph. Thin membranes called oval & round windows separate the inner ear & the middle ear. In this article know about the Perilymph Fistula Causes, symptoms, treatment.
However, these membranes can rupture due to a variety of causes, which leads to the perilymphatic fluid flowing from the inner ear into the middle ear. The pressure changes from the resulting fluid exchange can cause problems with the patient’s balance & hearing.
Perilymph Fistula Symptoms:
Some of the most common perilymph Fistula symptoms are:
- The ear feeling full
- Sudden, unexplained hearing loss
- hearing loss that frequently comes & goes
- Dizziness &/or vertigo
- Persistent, mild nausea
- memory loss
- motion sickness
- Feeling unbalanced or tilting to one side of the body
- ringing in the ears
Certain activities can worsen your perilymph fistula symptoms. These include:
- experiencing changes in altitude
- Lifting something heavy
- Sneezing strongly
- Coughing strongly
- Laughing with force
It’s also important to understand that not all patients experience similar symptoms. Some experience mild symptoms, while some others experience no symptoms at all. Some others report feeling just a little queasy & ill-at-ease.
Although Perilymph Fistula usually only affects one ear at a time, in certain cases, it is possible for patients to experience bilateral perilymph fistula too.
Perilymph Fistula Causes:
Perilymph Fistula causes include various activities & natural phenomena. Some of those are experiencing sudden head trauma or barotrauma (a condition that involves rapid, extreme changes in pressure). This pressure change can be brought on by several reasons, some of which include scuba diving, childbirth, air travel, heavy lifting, etc.
Other potential Perilymph Fistula causes could be:
- Eardrum puncture
- Exposure to loud sounds like gunshots or sirens, very close to your ear
- Frequent & serious ear infections
- Blowing your nose very hard
In some cases, Perilymph Fistula can also be present in a patient since birth. In yet other cases, perilymph fistula cases can occur spontaneously, without any probable cause. A majority of these spontaneous cases are caused by an old injury to the inner ear membranes, which might not have caused any noticeable symptoms previously.
Perilymph Fistula diagnosis
Perilymph Fistula can be difficult to diagnose as an individual condition. Some of its symptoms like dizziness, headache, etc. can be indicators of other conditions like a traumatic brain injury, or a concussion as well. Primary Perilymph Fistula symptoms are also quite similar to those of Meniere’s disease, an inner ear disorder that causes balance disorders & hearing loss in patients. It’s also easy to confuse its symptoms with Vertigo, another vestibular disease that causes dizziness, nausea, headache, & spinning sensations in patients.
It’s very important to get an accurate diagnosis of your condition, as Perilymph Fistula Treatment differs greatly from Vertigo treatment, Meniere’s disease treatment, etc. Your doctor will likely use a variety of Perilymph Fistula diagnosis tests to see if you’re indeed experiencing Perilymph Fistula.
Some of these tests include:
- Hearing tests to check the functionality of the patient’s ears
- Balance tests to check the functioning of the inner ear
- CT Scans
- MRI Scans
- Electronystagmography test.
The test checks & logs your inner ear activity in response to different sounds & determines if the fluid pressure in your inner ear is in the normal range,
- Perilymph Fistula diagnosis test that checks your eye movements while your external auditory canals are under externally applied pressure
Test administrators usually take into factor your medical history & test results to accurately determine whether you’re suffering from Perilymph Fistula. MRI & CT scans usually offer the confirmation needed, while in some cases doctors use surgical confirmation.
Perilymph Fistula treatments
Perilymph Fistula treatment strategies often depend on the exact symptoms you’re experiencing. In the beginning, your doctor might prescribe you simple bed rest & activity restriction for about 2-3 weeks to give the condition time to heal on its own. If this approach works & your condition shows improvement, your doctor might continue with this line of treatment. If your condition shows no improvement, then as a second line of Perilymph Fistula treatment your doctor might recommend the Blood Patch Injection.
The Blood Patch Injection involves injecting blood taken from other parts of your body. into the middle ear to repair the broken membrane between the inner ear & the middle ear. The Blood Patch Injection may also be used as a first-line of Perilymph Fistula treatment in some cases of Perilymph Fistula if your doctor deems it fit. Research conducted in 2016 on 12 Perilymph Fistula patients, all of whom had been given the Blood Patch Injection, revealed that all except one patient responded positively to the treatment, & showed improvement in their condition.
To ease the dizziness & vertigo symptoms caused by Perilymph Fistula, your doctor may prescribe you certain vertigo treatment exercises & medicines. This may include Vestibular Rehabilitation therapy, & vertigo medicines like antihistamines, betahistine, anti-dizziness medications, motion-sickness medications, nausea medicines, migraine medications, & herbal supplements like Ginkgo Biloba, etc. These don’t help in Perilymph Fistula treatment, but rather provide relief from some perilymph fistula symptoms.
Is Perilymph Fistula surgery really necessary?
If both of the above-mentioned treatments don’t work, perilymph fistula surgery might be the only option left for you. The procedure usually takes around 30-60 minutes to complete. In this, your doctor lifts your eardrum via your ear canal in order to place tissue grafts between your inner ear & middle ear. Here tissue grafts act as a temporary membrane between the middle ear and the inner ear until the old membrane repairs itself or the tissue grafts are absorbed by the body.
It’s a normal occurence for patients to experience a little dizziness after the surgery for up to three days. After this period, you’ll likely begin to recover from the surgery & will soon be able to experience normal ear functioning. However, it’s seen that in some cases, even Perilymph Fistula surgery doesn’t improve all Perilymph Fistula symptoms.
However, not all is lost, as patients record some relief from dizziness, headache & persistent ringing. This happens because the surgery restoring the fluid pressure in the inner ear. All are the recommended absolute bed rest for three full days immediately after the surgery.
For faster post-surgery recovery, you also need to strictly follow these rules:
- Avoid lifting objects heavier than 10 pounds in weight,
- Avoid activities that can potentially cause strain to the nerves, like diving, rock climbing, marathon running, lifting weights, etc. for some time
- Sleep with your head elevated to maintain the proper amount of fluid pressure in the inner ear.
You’ll need to stick to these guidelines for at least the next several weeks to a month & sometimes even longer. The recovery period for each individual differs based on their condition & response to the surgery. On average, it usually takes about 1 month to recover from the surgery. It’s important to follow the instructions your doctor gives you to speed up your post-surgery recovery period. It will help your perilymph fistula heal completely.
NeuroEquilibrium range of clinics has developed an effective line of treatment using virtual reality technology to reduce Perilymph Fistula disease. Perilymph Fistula patients have shown to benefit greatly from this treatment module.