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논문 기본 정보

자료유형
학술저널
저자정보
김종세 (성균관대학교) 손세은 (삼성서울병원) 김민범 (성균관대학교) 조영상 (삼성서울병원) 정원호 (삼성서울병원)
저널정보
대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제14권 제3호
발행연도
2021.8
수록면
268 - 277 (10page)
DOI
https://doi.org/10.21053/ceo.2020.01942

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Objectives. Patients’ clinical presentation is critical for identifying suspected perilymphatic fistula (PLF). The involvement of third-window lesions in the pathomechanism of PLF has been hypothesized. This study investigated the clinical features of PLF and the relationship of the third-window effect with PLF. Methods. Sixty patients underwent surgical exploration for suspected PLF and the oval and round windows were reinforced. Clinical features including demographics, pure-tone audiometry (PTA), and videonystagmography were evaluated preoperatively and 1 month postoperatively. Surgical outcomes were analyzed according to the improvement of hearing and vestibular symptoms and signs. The conductive components of PTA (air-bone gap [ABG]) were measured, and the relationship between ABG closure after surgery and hearing improvement was analyzed. In addition, postoperative subjective dizziness was assessed by clinical interviews. Changes in positional nystagmus were analyzed according to ABG closure and hearing improvement. Results. ABG at lower frequencies (LFABG; 250 Hz, 500 Hz, 1,000 Hz) was present in 27 patients (45%). Postoperatively, PTA significantly improved after surgical repair. Among the patients with preoperative LFABG (n=27), 15 (55.5%) showed postoperative ABG closure and significant improvement in PTA at all frequencies compared with the patients without ABG closure (P=0.012). Subjective dizziness improved in 57 patients (93.3%). Positional nystagmus was found in 45 of 49 patients. Multiple canal involvement was more common than single canal involvement (67% vs. 33%). The horizontal semicircular canal was most commonly involved, followed by the posterior and anterior canals. Postoperatively, positional nystagmus disappeared, or the number of involved canals decreased in 22 of 34 patients (64.7%). Conclusion. Pseudo-conductive hearing loss at lower frequencies and positional nystagmus originating from multiple semicircular canals were common findings in PLF. Surgical reinforcement of the oval and round windows improved the hearing threshold accompanied by closure of ABG. A third-window lesion might explain these clinical features of PLF.
#Perilymph #Nystagmus #Hearing Loss

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참고문헌 (23)

참고문헌 신청
Goodhill V / 1973 / Sudden deafness and labyrinthine window ruptures: audio-vestibular observations / Ann Otol Rhinol Laryngol 82(1):2~12 google schola Choi JE / 2017 / Diagnostic criteria of barotraumatic perilymph fistula based on clinical manifestations / Acta Otolaryngol 137(1):16~22 google schola Ahn J / 2019 / Surgical outcomes on hearing and vestibular symptoms in barotraumatic perilymphatic fistula / Otol Neurotol 40(4):e356~e363 google schola Ho ML / 2017 / Spectrum of third window abnormalities: semicircular canal dehiscence and beyond / AJNR Am J Neuroradiol 38(1):2~9 google schola Merchant SN / 2008 / Conductive hearing loss caused by third-window lesions of the inner ear / Otol Neurotol 29(3):282~289 google schola

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