Traumatic perilymphatic fistulae : About 13 cases

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Published May 9, 2011
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Vol. 89 No. 5 (2011): Issue May 2011

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Nadia Kaffel
Noura Jlassi
Zied Selmi
Riadh Boulakbeche
Rim Lahiani
Dalenda Nejah
Mamia Ben Saleh
Hela Hajri
Mohamed Ferjaoui

Abstract

Background: Post-traumatic peri-lymphatic fistulas have been described following ear and temporal bone injury, particularly in the setting of temporal bone fractures. The symptoms and signs of perilymphatic fistulae (PLF) are very varied and frequently misleading. The diagnosis can be suspected on the bases of the
clinical and the audiometrial findings. Indications for exploratory surgery in cases of trauma are vague and not well described.
Aim: To assess the principal clinical and radiologic signs of PLF.
Method: Study of 13 patients with different symptoms of posttraumatic peri-lymphatic fistulae.
Results: Ten patients had vertigo, and 2 presented otoliquorreha.
Two patients had tympanic perforation. Nine patients presented neurosensorinal hearing loss and 5 were completely deaf. A CT Scann was realized in 12 cases and showed the fracture in 10 cases (91%) with a pneumolabyrinth in 4 cases. Medical and postural treatment was indicated for all the patients then a surgery was indicated in all of them in an average wait of 4 months realizing an ear exclusion in one case and a filling-up for 12 patients. Vertigo improved in 10 cases and the hearing loss in 2cases.
Conclusion: The diagnostic of perilymphatic fistulae is not easy. The trauma and the clinical signs can help but the confirmation is surgical. The indication of surgery and its timing are still discussed.

Keywords:

Cranio-cerebral trauma, Fistula, Perilymph, Symptomatology, Diagnosis, Treatment, Tympanoplasty, Evolution, Postoperative

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