Abstract
We report a case of traumatic perilymphatic fistula caused by an ear pick, diagnosed on the basis of pneumolabyrinth seen on a CT scan. A 46-year-old man presented with hearing loss, tinnitus, vertigo, and nausea just after inserting an ear pick into his right ear. A perforation that extended from the anterior inferior quadrant through the posterior superior quadrant of the tympanic membrane was observed. Leftward horizontal rotatory mixed nystagmus was noted. Standard pure-tone audiometry indicated a mixed hearing loss of 96.7dB with an A-B gap of 36.7dB. Temporal bone CT showed low-density areas in the vestibule, lateral semicircular canal, and cochlea, suggesting the penetration of air bubbles. On the basis of these findings, traumatic perilymphatic fistula with pneumolabyrinth was diagnosed. The middle ear was operated on and the fistula was successfully plugged. After the operation, dizziness was alleviated immediately. However, 4 months after surgery, standard pure-tone audiometry continued to show a 75.0-dB hearing level with an A-B gap of 20.0dB.
