A perilymph fistula is a tear in the membranes separating the middle and inner ear, causing fluid pressure differences that lead to balance disorders and hearing problems. Symptoms include fullness in the ear, sudden hearing loss, dizziness, and more, often exacerbated by activities such as sneezing or lifting heavy objects. Diagnosis involves various tests, and treatment options range from bed rest to blood patch injections, with surgery as a last resort; recovery requires strict adherence to guidelines to ensure proper healing.

1. Perilymph Fistula causes, Symptoms
and treatment

3. A Perilymph Fistula can be described as a tear in
one of the membranes separating our middle &
inner ear. Our middle ear is filled with air, while
our inner ear, on the other hand, is filled with a
fluid called perilymph. The inner ear & the middle
ear are usually separated by thin membranes
called oval & round windows. In the event that
one or more of these membranes have a tear in
them, it causes perilymphatic fluid in the inner ear
to flow out into the middle ear.

4. This inadvertent fluid exchange creates a
difference in the fluid pressure of the inner ear.
The nerves & otolithic organs situated in our
inner ear are associated with maintaining our
balance while standing, walking, sitting, etc.
This difference in fluid pressure in the inner
ear leads to balance disorders & hearing
problems.

5. Perilymph Fistula symptoms include:
 A feeling of fullness in your ear
 Sudden hearing loss
 Inconsistent hearing loss
 Dizziness &/or Vertigo symptoms
 Persistent, mild nausea
 Temporary memory loss
 Motion sickness
 A feeling of unbalance, particularly to one side
 Recurrent headaches
 Persistent ringing in the ears

6. Perilymph Fistula symptoms can worsen when
you’re doing any of these things:
 Experience altitude changes
 Lift heavy things
 Sneeze
 Cough
 Laugh

7. Some perilymph fistula patients don’t experience
any symptoms, while others show mild symptoms
that are hardly noticeable.
Some people report simply feeling somewhat ‘off’
& not ‘in tune’ with their bodies.
Although Perilymph Fistula only affects one ear at
a time, in certain cases, severe head trauma can
lead to bilateral perilymph fistulas in rare cases.

8. Perilymph Fistula can happen after you experience
certain head trauma or barotrauma(a condition
that involves extreme, rapid changes of pressure).
Several reasons lead to this pressure change; air
travel, childbirth, scuba diving, heavy lifting, etc.

9.  Experiencing whiplash
 Puncture in the eardrum
 Being exposed to loud sounds like gunshots or
sirens, very close to your ear
 Frequent, serious ear infections
 Blowing your nose very hard

10. In some instances, Perilymph Fistula can also be
present in a patient since birth.
In some other cases, patients report developing
perilymph fistula cases spontaneously, without
any immediate or apparent cause.
A major cause for these spontaneous cases is
usually an old injury to the inner ear membranes,
which might not have caused any immediate
symptoms at the time of it happening.

11. Perilymph Fistula can be difficult to diagnose as a
standalone condition. Post-trauma symptoms such
as dizziness, headache, etc. can be linked to other
conditions like a traumatic brain injury with a
concussion.
Primary Perilymph Fistula symptoms also have a
lot of similarities to Meniere’s disease, a disorder
of the inner ear that causes balance disorders &
hearing loss among patients.

12.  . It’s also easy to confuse its symptoms with
Vertigo, another vestibular disease that arises
out of a fluid disbalance in the inner ear &
causes dizziness, nausea, headache & a
spinning sensation among patients.
 Read up more on Vertigo, its symptoms,
diagnosis & treatment in detail here.

13. It’s super important to ensure that your healthcare
provider gives you the correct diagnosis, as
Perilymph Fistula Treatment & treatments for
other vestibular conditions like Vertigo, Meniere’s
disease, etc. are different.
Healthcare providers will use a variety of
Perilymph Fistula tests to diagnose the causes of
Perilymph Fistula in a patient.

14.  Hearing tests to ascertain the functionality of the
patient’s ears
 Balance tests to determine the functioning of the inner
ear
 CT Scans
 MRI Scans
 An electronystagmography test, also known as ENG
Test. The test looks at your inner ear activity in the
context of different sounds to determine if the fluid
pressure in your inner ear is abnormal,
 Perilymph Fistula test that keeps track of your eye
movements while applying pressure to your external
auditory canals

15. Healthcare providers usually consider a
combination of your medical history & test results
to determine whether a patient is suffering from
Perilymph Fistula accurately. The confirmation
often comes from MRI &/or CT scans, sometimes
also with a surgical exploration of the affected
area.

16. Perilymph Fistula treatments vary according to the
symptoms you’re experiencing.
At the onset, your doctor might prescribe you
something as simple & primitive as bed rest &
activity-restriction for about 2-3 weeks to minimize
the effects of the symptoms.
If this approach helps your symptoms to subside &
leads to improvement in your condition, your
healthcare provider might continue with this line
of treatment.

17.  If the above approach doesn’t work for you,
then your doctor might try a Perilymph Fistula
treatment called the Blood Patch Injection.
 The Blood Patch Injection is a fairly new
treatment for Perilymph Fistula that involves
injecting your own blood into your middle ear
to help patch up the broken window
membrane between the inner ear & the middle
ear.
 The Blood Patch Injection may also be used as a
first-line of Perilymph Fistula treatment in
some cases of Perilymph Fistula.

18. A 2016 research studied 12 Perilymph Fistula
patients, all of whom had been given the Blood
Patch Injection. The study recorded that all except
one of the patients responded positively to the
Blood Patch Injection, & showed improvement in
their conditions.

19. If both of the treatments mentioned above don’t
work, your doctor might recommend Perilymph
Fistula surgery to help ease your condition.
The surgery usually takes between 30-60 minutes,
during which your doctor lifts your eardrum
through your ear canal so tissue grafts can be
placed as a membrane between your inner ear &
middle ear.
Post-surgery, patients might experience a little
dizziness, which may last for up to three days.

20. After three initial days, the perilymph fistula
surgery recovery period begins, & you’ll soon be
able to experience normal ear functioning.
However, it’s important to remark that in certain
cases, even Perilymph Fistula surgery might not
improve or restore hearing loss in a patient,
congenital or post-traumatic.
These patients, however, might still experience
some relief from dizziness, headache & persistent
ringing, with the surgery restoring the fluid
pressure in their inner ear.

21. As part of the Perilymph Fistula surgery recovery
period, you’re required to take absolute bed rest
for three days immediately succeeding the
surgery.
You’ll also be directed by your doctor to adhere to
these few rules for faster post-surgery recovery:
 Avoid lifting objects heavier than 10 pounds,
 Avoid activities that could possibly cause
strain to your nerves, like diving, rock
climbing, marathon running, lifting weights,
etc.
 Sleep with your head elevated to maintain
proper fluid pressure in the inner ear.

22. You’ll need to stick to these guidelines for at least
the next several weeks to a month & sometimes,
even more, post your Perilymph Fistula surgery.
The recovery period for each individual differs
according to their condition & response to the
surgery, & is usually pegged at 1 month to a few
post-surgery.
It’s important to follow the guidelines laid out by
your healthcare provider strictly for the entire
duration of your post-surgery recovery period.
Otherwise, your Perilymph Fistula might not fully
heal.

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