Bilateral perilymph fistula
-
Upload
dusan-pavlovic -
Category
Health & Medicine
-
view
553 -
download
0
Transcript of Bilateral perilymph fistula
![Page 1: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/1.jpg)
Bilateral Perilymph Fistula
N. Arsović, D. Pavlović
Institute for ENT&MFS, Clinical Center of Serbia
Hearing and Balance Center Belgrade
![Page 2: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/2.jpg)
Controversy in otolaryngology
DusanPavlovic.com
Leak of perilymph at oval or round window No consistent symptoms No specific diagnostic test Doubtful intraoperative verification
Rome, October 19th 2015
![Page 3: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/3.jpg)
52yr male
DusanPavlovic.com
5yr of constant disequilibrium motion intolerance pour concentration positional vertigo and history of rec. BPPV Tinnitus Two head injuries 24 and 6yr ago
Rome, October 19th 2015
![Page 4: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/4.jpg)
Symmetrical s/n hearing loss
DusanPavlovic.com Rome, October 19th 2015
![Page 5: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/5.jpg)
Right canal paresis
DusanPavlovic.com Rome, October 19th 2015
![Page 6: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/6.jpg)
Normal VOR gain in all 6 canals
DusanPavlovic.com Rome, October 19th 2015
![Page 7: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/7.jpg)
CT: susp. defect at basal plate
DusanPavlovic.com Rome, October 19th 2015
![Page 8: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/8.jpg)
After right fistula closure
DusanPavlovic.com
patient improves a lot, but still rec. BPPV caloric test at right side improves absent oVEMP at right side (3w after surgery) cVEMP present at both sides hearing didn't change
Rome, October 19th 2015
![Page 9: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/9.jpg)
Responce at right side improves
DusanPavlovic.com
65%
23%
Rome, October 19th 2015
![Page 10: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/10.jpg)
6 month later, after left fistula closurepatient is without any vestibular symptoms
he starts to workhe's life completely
changed :)
![Page 11: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/11.jpg)
65%
23%
25%
![Page 12: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/12.jpg)
oVEMP at right side regain
DusanPavlovic.com Rome, October 19th 2015
![Page 13: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/13.jpg)
Conclusions
DusanPavlovic.com
unstable peripheral lesion chronic disequilibrium or off balance cognitive dysfunction SST positive surgical exploration and fistula closure
Rome, October 19th 2015
![Page 14: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/14.jpg)
Many thanks to Jeremy Hornibrook
![Page 15: Bilateral perilymph fistula](https://reader036.fdocuments.in/reader036/viewer/2022062902/58ee80821a28ab0d2a8b45e1/html5/thumbnails/15.jpg)
CANVAS, David Szmulewicz
Meniere’s disease, Mohamed Hamid
Vestibular Migraine, Michael von Brevern
bbf.rs
+ 3 workshops