Cases reported "Dizziness"

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1/4. Perilymphatic fistula in cabin attendants: an incapacitating consequence of flying with common cold.

    A perilymphatic fistula (PLF) is an abnormal communication between the inner ear and the middle ear that leaks perilymph. PLF is considered rare, but is known to occur during childbirth, straining, weightlifting, head trauma, and diving with middle ear equalizing problems. It has also, anecdotally, been described in connection with flying. The symptoms are uncharacteristic vertigo and, in some cases, hearing impairment and tinnitus. This study describes four cases of PLF during a period of 6 mo in a major Scandinavian airline company employing approximately 3000 cabin attendants (CAs). None of the cases were diagnosed at the primary health care level. All were referred to the aviation Medical Center for investigation. The PLF diagnosis was based on the case history, Platform pressure Test (a fistula test), and other vestibular tests. Only one CA has been able to return to flying duties. The article emphasizes the risk of flying with poor middle ear equalization and the necessity of reminding crews and airline companies to "never fly with a common cold".
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keywords = perilymphatic
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2/4. A case of perilymphatic fistula in blunt head injury.

    dizziness is a common symptom following blunt head injury. This is usually attributed to the "post-concussive" syndrome. Here we present a patient whose symptoms following head injury were a result of him having developed a perilymphatic fistula.
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keywords = perilymphatic
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3/4. dizziness after head trauma: clinical and morphologic findings.

    Twelve patients with balance problems resulting from head injury were treated by a translabyrinthine or middle fossa vestibular neurectomy. The clinical, otoneurologic, and surgical data combined with morphologic findings on the removed operative eighth nerve specimens were evaluated with the aim of deciding the site of primary lesion in each case. In six patients a peripheral lesion was interpreted. Four of them had features of delayed endolymphatic hydrops syndrome, the fifth patient might have suffered a fracture of the stapedial footplate with associated perilymphatic fistula. The sixth patient had a deforming fracture of the internal auditory canal that had produced severe hearing loss and constant unsteadiness because of the compression of the eight nerve, which had atrophied as a result. Half of the patients were diagnosed as having a central lesion. Only one of them benefited from the neurectomy. This patient had a large arterial loop within the internal auditory canal and the symptoms may have arisen because of friction of the vessel of the proximal portion of the vestibular nerve. The other five patients probably had a lesion at the level of eighth nerve brain-stem junction or central to it.
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keywords = perilymphatic
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4/4. Persistent dizziness following head trauma and perilymphatic fistula.

    A growing body of evidence supports the idea that dizziness that persists for months and even years can be caused by an unsuspected perilymphatic fistula. Perilymphatic fistulas are abnormal ruptures that allow perilymph to leak out of the inner ear into the middle ear space. Most commonly, these ruptures occur secondary to a traumatic event. The term postconcussive syndrome has been used to describe a myriad of symptoms following head trauma. Some of these symptoms, such as cognitive changes, tinnitus, neck stiffness, and dizziness, are also commonly caused by active perilymphatic fistulas. This article discusses the typical history and diagnostic tests for patients with perilymphatic fistula. Common diagnostic tests include audiograms, electronystagmograms, electrocochleograms, and subjective and platform fistula tests. Also, the surgical treatment for the perilymphatic fistula (ie, repair of the oval and round windows) is reviewed, along with the results produced by this relatively minor ear operation. Suggestions are made to help the medical professionals involved in rehabilitative care to be aware of perilymphatic fistulas and seek proper consultations from inner ear specialists if they suspect the existence of this easily cured disorder.
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ranking = 9
keywords = perilymphatic
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