Has anyone ever had a perilymph fistula or know anything about it?

My husband has been diagnosed with a perilymph fistula in his middle ear and is awaiting surgery for a graft in Feburary would appreciate if anyone had any info or experience on the condition

Background: A perilymph fistula (perilymphatic fistula, labyrinthine fistula) is an abnormal communication between the fluid-filled perilymphatic space of the inner ear and the air-filled middle ear cavity, usually through the round or oval windows. This results in sensorineural hearing loss and/or vestibular symptoms.

This clinical entity was proposed more than a century ago, yet it remains a topic of controversy, especially regarding the existence of "spontaneous" etiologies. The diagnosis is made by clinical history and otoneurological tests. A definitive diagnosis is made at surgery, although the use of surgical findings as a criterion standard for this entity has been questioned.

In the absence of prior surgery or definite traumatic event, it may be difficult to distinguish a perilymph fistula from M茅ni猫re syndrome.


Pathophysiology: Most commonly, a tear in the round or oval window leads to loss of perilymph into the middle ear. This condition may be the result of stapes prosthesis surgery, trauma, barotrauma, or bony erosion due to infection or neoplasm, or it may be idiopathic. In children, perilymph fistulas are associated with congenital anomalies of the middle or inner ear.


Mortality/Morbidity: In children, the condition may be associated with recurrent meningitis. Acute or chronic perilymph fistulas may significantly affect quality of life.

Sex: Prevalence is higher in females than in males.

Age: Perilymph fistulas occur in young children with congenital abnormalities; otherwise, the condition is not known to be age specific.



History:

Sensorineural hearing loss that may be sudden or fluctuating
Aural fullness
Vestibular symptoms
Vertigo - With or without head position changes
Dysequilibrium
Motion intolerance
Nausea and vomiting
Disorganization of memory and concentration
Perceptual disorganization in complex surroundings such as crowds or traffic
Tinnitus occurs in some cases and can be roaring in nature.
Physical:

Positive test results for vestibular dysfunction or hearing loss, while helpful, are not pathognomonic.
Romberg (feet together) or tandem Romberg (heel-to-toe) test findings may be positive.
Positional nystagmus and benign paroxysmal positional vertigo often are associated with traumatic perilymph fistula.
Sensorineural hearing loss may be confirmed by audiograms.
Causes:

Prior stapes surgery - Less frequent with new techniques
Head trauma, including whiplash injuries
Barotrauma (scuba-diving鈥搑elated ear squeeze)
Acoustic trauma
Idiopathic or spontaneous, possibly related to episodes of valsalvae, nose blowing, or physical exertion (The existence of spontaneous perilymph fistula is still an area of controversy among otologists.)