Perilymphatic fistula

Japanese: 外リンパ瘻 - がいリンパろう（英語表記）Perilymphatic fistula

What is the disease?

Located between the middle and inner ear Inner ear window ( No jisou ) ( Round window ( Competition ) and Oval window ( Ranenso ) ) for some reason Perforation ( flash ) This is a disease that causes hearing loss and dizziness due to the formation of small holes in the eyes.

What is the cause?

Lifting heavy objects, carrying heavy objects, straining on the toilet, blowing your nose, diving in the ocean, etc. Cerebrospinal fluid pressure ( Zuiekiatsu ) It is known that perforation of the inner ear window can occur when there is a sudden increase in middle ear pressure or when the ear is in a congested position. Other causes include head trauma and air travel.

How symptoms manifest

Cochlea ( Captivity ) Symptoms (hearing loss, Sensation of ear congestion ( World War II ) , tinnitus) only, Front yard ( Total ) There are various types, including cases where only symptoms are present (dizziness, balance problems) or cases where cochlear and vestibular symptoms are also present.

These symptoms may occur suddenly at the same time as the cause, but they may worsen over several days or may improve and worsen repeatedly. As such, the symptoms do not appear in the same way and vary from person to person. A popping sound may be heard when the condition first occurs.

Testing and diagnosis

At present, there is no definitive method of diagnosis other than performing surgery to confirm a perforation in the cochlear window. However, if cochlear or vestibular symptoms occur after the behavior or environment that may cause a perforation in the cochlear window as described in the cause section, if a characteristic popping sound is confirmed at the time of onset, if a characteristic tinnitus like running water appears, or if dizziness is complained of when pressure changes are applied to the outer or middle ear, the presence of a perilymphatic fistula is suspected.

Treatment methods

Conservative treatment such as resting may cure the condition. However, if the dizziness is severe, the hearing loss progresses, or the condition is caused by a head injury, immediate middle ear surgery ( Tympanic cavity ( Koshitsu ) An open procedure is performed, and the location of the perforation in the inner ear window is confirmed and then closed.

What to do if you notice an illness

If a perilymphatic fistula is suspected, it is important to stay as still as possible, avoid any movements or exercise that may cause the problem, and see an otolaryngologist as soon as possible.

Hideo Masazumi

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　中耳と内耳の間にある内耳窓(ないじそう)（正円窓(せいえんそう)と卵円窓(らんえんそう)）に何らかの原因により穿孔(せんこう)が生じた（小さな穴があく）ため、難聴、めまいを発生する病気です。

原因は何か

　重い物を持ち上げる、運ぶなどの力仕事をする、トイレでいきむ、鼻をかむ、海に潜るなど、髄液圧(ずいえきあつ)や中耳圧が急激に上昇する場合に内耳窓に穿孔が生じることが知られています。そのほか、頭部外傷や飛行機旅行も原因になります。

症状の現れ方

　蝸牛(かぎゅう)症状（難聴、耳閉感(じへいかん)、耳鳴り）だけの場合、前庭(ぜんてい)症状（めまい、平衡障害）だけの場合、蝸牛・前庭症状がみられる場合と、いろいろなタイプがあります。

　これらの症状は原因と同時に突然起こることもありますが、数日かけて悪化する場合や症状が改善・悪化を繰り返す場合もみられます。このように、症状の現れ方は一様ではなく、個人差があるのが特徴です。なお、発症時にパチッという音（ポップ音）が聞こえることがあります。

検査と診断

　現時点では、手術をして内耳窓に穿孔を確認する以外に確実な診断法はありません。しかし、原因の項で示したような内耳窓に穿孔を生じる可能性のある行動、環境のあとに蝸牛症状や前庭症状が生じた場合、発症時の特徴的なポップ音が確認された場合、水の流れるような特徴的な耳鳴りが現れる場合、外耳や中耳に圧変化を加えた時にめまいを訴える場合には、外リンパ瘻の存在が疑われます。