2023 Volume 163 Pages 1-5
In cases of suspected perilymphatic fistula (PLF) as the cause of dizziness and/or acute sensorineural hearing loss, we instruct patients to rest for several days with the head raised. Thereafter, if the symptoms do not improve, surgery is performed. Between January 2016 and December 2019, we treated 28 cases of PLF by surgery at Kurume University Hospital, and examined the triggers and symptoms at onset, nystagmus pattern, surgical findings, and treatment outcomes. In most cases, there were no triggers for the symptom onset. Vestibular symptoms were observed in 92.9% of cases. Sensorineural hearing loss was observed in 82.1% of cases. Vestibular function tests showed positional nystagmus in 82.1% of cases. During surgery, fistulas were confirmed in 14.3% of cases and perilymphatic fluid leakage in 64.3% of cases. The hearing loss improved after the surgery in 26.1% of cases. The improvement rate of hearing loss was 80.0% for patients who underwent surgical treatment within 2 weeks of onset. The overall improvement rate of vestibular symptoms was 88.5%. Even in cases treated a long time after the disease onset, the rate of improvement of vestibular symptoms was good. Surgical treatment should be considered for cases of suspected PLF.
