Citation, DOI, disclosures and article data
Citation:
Wahba M, Bell D, Weerakkody Y, et al. Perilymphatic fistula. Reference article, Radiopaedia.org (Accessed on 05 Oct 2024) https://doi.org/10.53347/rID-6887
A perilymphatic fistula (also known as a labyrinthine fistula) is a pathologic communication between the fluid-filled space of the inner ear and the air-filled space of the middle ear, most commonly occurring at either the round or oval window.
Clinical presentation
Symptoms of perilymphatic fistula may include:
- sensorineural hearing loss
- vertigo
- nausea
- tinnitus
- spatial disorientation
- dizziness
- ear fullness
Radiographic features
CT
- may demonstrate fluid-filling in the round window (especially if >2/3 of the round window niche) or in the oval window niche (considered most common sign 6
MRI
- may demonstrate fluid-filling in the round window (especially if >2/3 of the round window niche) or in the oval window niches (considered most common sign 6
- may demonstrate a round window sign
- defined as a nodular FLAIR high signal in the round window and the presence of associated saccular hydrops 7
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4. Maitland CG. Perilymphatic fistula. Curr Neurol Neurosci Rep. 2002;1 (5): 486-91. Pubmed citation
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5. Al Felasi M, Pierre G, Mondain M et-al. Perilymphatic fistula of the round window. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128 (3): 139-41. doi:10.1016/j.anorl.2010.12.004 - Pubmed citation
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6. Venkatasamy A, Al Ohraini Z, Karol A, Karch-Georges A, Riehm S, Rohmer D, Charpiot A, Veillon F. CT and MRI for the diagnosis of perilymphatic fistula: a study of 17 surgically confirmed patients. (2020) European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 277 (4): 1045-1051. doi:10.1007/s00405-020-05820-3 - Pubmed
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7. Dubrulle F, Chaton V, Risoud M, Farah H, Charley Q, Vincent C. The round window sign: a sensitive sign to detect perilymphatic fistulae on delayed postcontrast 3D-FLAIR sequence. (2020) European radiology. 30 (11): 6303-6310. doi:10.1007/s00330-020-06924-4 - Pubmed
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