Traumatic perilymphatic fistula; a rare entity

Abstract

Perilymph fistula is an abnormal communication between inner ear and middle ear cavity or mastoid causing perilymph leakage. The symptoms are vertigo, hearing loss, tinnitus, and aural fullness. Its management varies with variable outcome of hearing and vestibular function. A 32-year female with penetrating injury to the right ear causing dizziness and hearing loss presented with findings of bruise in external auditory canal along with dry central perforation and horizontal nystagmus in positional test. She had profound hearing loss and pneumolabyrinth. Successful surgical repair of perilymphatic fistula was performed with improved hearing and resolution of vestibular symptom. A high index of clinical suspicion is required for good outcome possible with early treatment. The surgical management with exploratory tympanotomy and fistula repair is advocated in patients with progressive hearing loss and non-resolving vertigo.
Keywords: Nystagmus, penetrating injury, perilymphatic fistula, tympanotomy, vertigo