Barotraumatic Perilymphatic Fistula and Tympanometry in Lateral Position.

概要

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The presence of a perilymphatic fistula has been difficult to determine because of the lack of efficient and reliable testing methods. The condition is suspected on the basis of the history alone and is confirmed by surgery.Our previous studies have shown that when a patient with mild dysfunction of the eustachian tube lies on his side, the lower middle ear cavity pressure becomes markedly positive.It is important to differentiate perilymphatic fistula (PLF) from other inner ear disease, and the purpose of this study was to clarify by positional tympanometry mild dysfunction of the eustachian tube with barotraumatic PLF.Using the peak values of the tympanogram in the lateral position (TLP), we analyzed the changes in pressure of the lower tympanomastoid cavity in ears with PLF and in patients with sudden deafness.In patients with PLF, there was a significant increase in the internal pressure of the affected lower cavity, which rose to 81.0±4.4 mmH2O after 10 min (Nor. 27.7±16.8 mmH2O). On the other hand, in patients with sudden deafness, middle ear pressure was 24.13±8.00mmH2O after 10 min.These results suggest that when there is a strong possibility of barotraumatic PLF, we can utilize TLP for the diagnosis of PLF. Once there is a marked elevation of the affected ear cavity pressure in TLP, exploratory tympanotomy must be done immediately.
耳鼻咽喉科臨床学会の論文