Two Cases of Perilymphatic Fistula with Hearing Loss Caused by Nose-blowing

Abstract

Perilymphatic fistula (PLF) is defined as an abnormal leakage of perilymph from the inner ear to the middle ear. High pressure of the middle ear destroys the connection between the stapes and vestibular window. We report two cases of PLF caused by sniff. One case complained fluctuating hearing loss, and was diagnosed with PLF before operation because Coclin-tomoprotein (CTP) detection test was positive. Hearing loss improved after surgery. The other case complained of severe vertigo and hearing loss, and was suspected with PLF because air embolisms were detected in the inner ear. The intraoperative CTP detection test was negative. We believe this may be due to complete depletion of the perilymph through the fistula, causing irreversible hearing loss even after surgery. The CTP detection test is useful in diagnosing PLF, but test results must be interpreted based on the timeline of the disease process. Development of a faster method of diagnosis and education of health care providers about this rare disease are desirable.