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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Labyrinthine fistula of the round window should be considered in the differential diagnosis of vertigo and sudden hearing loss occurring in patients, who are not only divers, during physical stress or exertion. Surgical exploration and closure of the fistulae are the only means of diagnosis and treatment of this condition. Since these fistulae may heal spontaneously in most instances early surgery is recommended after a short interval of conservative therapy. Five patients, of whom 4 underwent surgery and one was seen for an expert opinion are presented.
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PMID:[Rupture of the round window membrane (author's transl)]. 47 99

Perilymph fistula occurs when endolymph and perilymph mix, or when perilymph leaks into the middle ear space. Sensorineural hearing loss and/or vertigo may result. This paper reviews the pertinent anatomy and physiology of the inner ear, clinical presentations, diagnosis, treatment, and prognosis as a guide for the clinician.
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PMID:Perilymph fistula. 407 Nov 74

Perilymph fistula is caused by changes of cerebrospinal fluid pressure and/or middle ear pressure. For diagnosis, history taking is extremely important in regard to whether the occurrence of symptoms is related to physical exertion, such as straining, nose blowing, sneezing etc. A variety of symptoms are due to pathologic changes of the membranous labyrinth. Exploratory tympanotomy is needed to verify the occurrence of leakage. However, perilymph fistula cannot be excluded, even if leakage is not observed. Management consists of absolute rest and closure of the fistula. If dizziness or vertigo is intractable and long-lasting, destruction of vestibular function should be considered.
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PMID:Perilymph fistula: concept, diagnosis and management. 807 86

Labyrinthine fistula is a complication of chronic otitis media with cholesteatoma which can result in progressive sensory hearing loss or permanent loss of inner ear function. Total surgical removal of cholesteatoma and use of the intact canal wall tympanoplasty and mastoidectomy can result in preservation or improvement of hearing and elimination of vertigo. Long-term results in a series of 63 cases are reported. The important features of surgical technique involve use of high magnification with the operating microscope, a high-speed drill, suction irrigation and thorough knowledge of temporal bone anatomy. In addition, the surgeon must avoid tearing or perforation of the squamous epithelium basement membrane during dissection. In some cases, sensory hearing returns to normal following surgery, making a successful second-stage reconstruction for hearing possible.
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PMID:Labyrinthine fistula from cholesteatoma: surgical management. 872 Oct 18

Labyrinthine fistula is a complication of chronic otitis media with cholesteatoma. Canal wall down tympanoplasty with partial mastoid cavity obliteration and complete removal of cholesteatoma matrix was adopted in five cases of labyrinthine fistula. The operation resulted in elimination of vertigo. Sensory hearing has been saved in two cases. Air conduction hearing improved in one case. In three cases whose air conduction deteriorated post-operatively, bone conduction worsened in two cases and remained unchanged in one case (Tympanoplasty type 0 was performed in the other one case.) During the follow-up period, otorrhea improved in all cases and there was no evidence of recurrence of cholesteatoma. If the hearing of the other ear is acceptable, we suggest one-stage canal wall down tympanoplasty with complete removal of cholesteatoma matrix and partial mastoid cavity obliteration. It provides low recurrence rate of cholesteatoma and there is no need of re-operation.
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PMID:Management of labyrinthine fistula in middle ear cholesteatoma. 951 88

Perilymph fistula is caused by an abnormal communication between the perilymph space and the middle ear. The etiology is either congenital or acquired. The congenital fistula can be associated or not with clinical symptoms or radiologically detectable abnormalities of the temporal bone. In patients presenting congenital fistula without symptoms or radiologically detectable abnormalities, little malformations of the middle ear may be detected during surgery. The acquired fistula can be caused by iatrogenic trauma, physical injury or erosion. As far as therapy is concerned, surgical treatment can be performed and the perilymph fistula thus represents one of the few causes of sensorineural hearing loss that can be treated surgically. However, the main challenge is the identification of those patients that need to undergo an exploratory tympanotomy, since there are no clinical-audiologic symptoms or radiographic indicators that can be considered pathognomonic of perilymph fistula. The aim of this review of the literature is to define the guidelines for preoperative diagnosis to indicate exploratory tympanotomy both in children and in adults. On the basis of our results, exploratory tympanotomy should be performed in patients with vertigo and/or progressive, sudden or fluctuating hearing loss in association with one or more than one of the following elements: a history of cranial trauma, radiographically detectable abnormalities of the inner ear, congenital malformations of the head, recurring meningitis, positive fistula test. The surgical treatment consists in placing a graft of temporalis fascia or tragal perichondrium and it usually results in a significant improvement of vestibular symptoms and sometimes of the hearing function as well.
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PMID:Congenital and acquired perilymph fistula: review of the literature. 1020 30

Migraine equivalents are the most common cause of vertigo in children and adolescents. Vertigo and balance disorders occur frequently in children during the course of otitis media, middle ear effusion and viral infections. If otitis media is associated with reduced hearing and vertigo, labyrinthitis must be considered. Craniocerebral injury is another important cause of vertigo in children. In contrast, spontaneous benign paroxysmal positional vertigo is rare among children. The isolated cases of endolymphatic hydrops that occur in children are usually secondary. Perilymph fistula can have congenital, infectious or trauma-related causes. The following characteristics are useful for differentiating between different vertiginous syndromes: type and duration of vertigo, triggering/aggravating/alleviating factors and accompanying symptoms. A neuro-ophthalmologic examination is essential to rule out central vestibular disorders.
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PMID:[Vertigo in children and adolescents. Part 1: Epidemiology and diagnosis of peripheral vestibular disorders]. 2396 61

This chapter will focus on vertigo/dizziness due to inner-ear malformations, labyrinthine fistula, otosclerosis, infectious processes, and autoimmune inner-ear disorders. Inner-ear malformation due to dehiscence of the superior semicircular canal is the most recently described inner-ear malformation. Vertigo/dizziness is typically induced by sound and pressure stimuli and can be associated with auditory symptoms (conductive or mixed hearing loss). Labyrinthine fistula, except after surgery for otosclerosis, in the context of trauma or chronic otitis media with cholesteatoma, still remains a challenging disorder due to multiple uncertainties regarding diagnostic and management strategies. Otosclerosis typically manifests with auditory symptoms and conductive or mixed hearing loss on audiometry. Vertigo/dizziness is rare in nonoperated otosclerosis and should draw clinical attention to an inner-ear malformation. Computed tomography scan confirms otosclerosis in most cases and should rule out an inner-ear malformation, avoiding needless middle-ear surgical exploration. Labyrinth involvement after an infectious process is unilateral when it complicates a middle-ear infection but can be bilateral after meningitis. Labyrinth involvement due to an inflammatory disease is a challenging issue, particularly when restricted to the inner ear. The diagnosis relies on the bilateral and rapid aggravation of audiovestibular symptoms that will not respond to conventional therapy but to immunosuppressive drugs.
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PMID:Otologic disorders causing dizziness, including surgery for vestibular disorders. 2763 78