A perilymph fistula refers to a tear or opening in the ‘perilymphatic space’ - the fluid filled area found in your inner ear. This tear allows the fluid to leak into the air-filled middle ear which can make you feel dizzy, affect your hearing, cause tinnitus and vertigo.
Diagnosing a perilymph fistula can be tricky since the symptoms are often related to lots of other causes which will need to be ruled out first.
Symptoms of a perilymph fistula
The symptoms of a perilymph fistula may include:
Dizziness – sometimes made worse by your own voice or listening to music
Nausea and/or vomiting
Hearing loss – both sudden and intermittent
‘Fullness’ in the ears
Some people find that their symptoms are worse with:
Changes in altitude or barometric pressure for example in lifts, planes or even when diving
Lifting something heavy or bending over
When coughing, sneezing or blowing their nose
General activity, although the symptoms ease when resting
In some cases, these symptoms can be mild, in others they can have a huge effect on your day-to-day life.
Diagnosing a perilymph fistula
Diagnosing a perilymph fistula can be really tricky because the symptoms are similar to other inner ear ailments such as Meniere’s disease. In most cases health professionals will take a full medical history and may use an MRI or CT scan to confirm a suspected tear.
They may also do some tests to see if your balance has been affected.
How is a perilymph fistula treated?
Once a perilymph fistula is diagnosed, the initial advice is to rest until it heals naturally and the liquid stops leaking into the middle ear.
If the symptoms persist, surgery may be required to repair the tear followed by a period of rest and the need to avoid heavy lifting.
What causes perilymph fistula
The most common cause of a perilymph fistula is a blow to the head or whiplash – for both ears to be affected it would have to be a severe trauma. Other causes include a perforated eardrum, pressure changes as a result of diving or rapid pressure changes in the head relating to weightlifting or even childbirth. A perilymph fistula can occur in both adults and children or could even be present from birth.
When to see a hearing specialist
If you experience a sudden hearing loss after a traumatic event, you should seek advice from a GP who may refer you to a specialist.
There are numerous causes including pressure changes, blows to the head or extreme exertion.
Sometime time is enough to heal a tear, in severe cases, surgery may be required.
A perilymph fistula itself is not painful but the symptoms can be extremely disruptive to your general wellbeing.