Timothy C. Hain, MD   • Page last modified: March 3, 2021

Vestibulfibrosis is an exceedingly rare inner ear condition in which there is coupling, usually due to scarring, between the stapes footplate and the utricle or saccule.

Persons with this disorder have strong and reproducible nystagmus induced by the "fistula" test -- a form of pressure sensitivity. They also ordinarily have "Tullio's" phenomena, and become dizzy with anything that makes their ear pop.

Differential diagnosis of this condition is largely limited to bony fistulae of the canals -- superior canal dehiscence, and cholesteatoma eroding through the lateral canal. Window fistulae do not cause reproducible nystagmus.

Treatment can be conservative, with medication, or chemical labyrinthectomy using gentamicin.

Case example:

A man developed strong vertigo with nausea and vomiting that lasted several weeks. 6 months later he continued to complain of dizziness. MRI scanning and hearing testing was normal. On examination there was no spontaneous nystagmus or vibration induced nystagmus, but application of positive and negative pressure to the external ear canal (the fistula test), produced a strong and reproducible nystagmus. Valsalva testing also created some nystagmus. The CT scan of the temporal bone (done to rule out SCD) was normal.

Comment: This is diagnosis of vestibulofibrosis by exclusion.