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Fistula Case 2

(round window perilymphatic fistula of the inner ear)

rw fistula

Timothy C. Hain, MD  

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A 33 year old man complained of vertigo. This were preceded by considerable diving. Five years prior to being evaluated, he had dizziness for a week following a 60-ft dive. A year later, he developed dizziness after a shallow dive. 3 years ago, he developed dizziness after returning from an international flight. He was diagnosed as having labyrinthitits. A year later, he developed dizziness, again after a descent in an airplane. Two years go, while taking a trip on the subway, his ears "popped", and he developed a "giant vertigo experience".

He was thought by several clinicians to have a perilymphatic fistula, and was operated on by a well known ear surgeon. According to the operative report, no fistula was seen, but a graft was placed.

Symptoms continued to gradually worsen and made him so ill that he was unable to travel by air due to fear of flying.

Testing was done --

Management and course

Insertion of a ventilation tube was recommended, but not acted upon. Verapamil was found to be helpful in reducing motion sensitivity. After several years, he was reexplored and a large RW fistula was found and repaired. All symptoms resolved at that point.

Points:

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Copyright August 3, 2016 , Timothy C. Hain, M.D. All rights reserved. Last saved on August 3, 2016