Res Vestib Sci.  2015 Mar;14(1):26-31. 10.0000/rvs.2015.14.1.26.

Two Cases of Barotraumatic Perilymph Fistula Mimicking Atypical Benign Paroxysmal Positional Vertigo with Sudden Hearing Loss

• Lee JJ
• Ryu G
• Moon IJ
• Chung WH

• KMID: 1787781
• DOI: http://doi.org/10.0000/rvs.2015.14.1.26

Abstract

Barotraumatic perilymph fistula is difficult to diagnose and needs diagnosis of suspicion. Symptoms like hearing loss, tinnitus, ear fullness and positional dizziness can develop following barotrauma such as valsalva, nose blowing, straining and diving, etc. We reported 2 cases of perilymph fistula following barotrauma. The patients developed hearing loss, tinnitus and ear fullness followed by sudden onset of positional dizziness mimicking benign paroxysmal positional vertigo (BPPV). On positional tests, the direction of nystagmus has changed over time. In addition, the characteristics of nystagmus on positional test were not similar to typical BPPV, which showed longer duration of nystagmus, no reversibility and no fatigability. We concluded that barotraumatic perilymph fistula could present as hearing loss with positional dizziness mimicking sudden hearing loss with BPPV. The differential diagnostic points were history of barotrauma, time sequence of development of hearing loss and positional dizziness, and atypical positional nystagmus unlike BPPV.

Keyword

Perilymph; Fistula; Barotrauma; Benign paroxysmal positional vertigo

MeSH Terms

Barotrauma
Diagnosis
Diving
Dizziness
Ear
Fistula*
Hearing Loss
Hearing Loss, Sudden*
Humans
Nose
Nystagmus, Physiologic
Perilymph*
Tinnitus
Vertigo*