Fitzgerald D C
Department of Otology/Neurology, Washington Hospital Center, Washington, DC 20010, USA.
Arch Phys Med Rehabil. 1995 Nov;76(11):1017-20. doi: 10.1016/s0003-9993(95)81041-2.
A growing body of evidence supports the idea that dizziness that persists for months and even years can be caused by an unsuspected perilymphatic fistula. Perilymphatic fistulas are abnormal ruptures that allow perilymph to leak out of the inner ear into the middle ear space. Most commonly, these ruptures occur secondary to a traumatic event. The term postconcussive syndrome has been used to describe a myriad of symptoms following head trauma. Some of these symptoms, such as cognitive changes, tinnitus, neck stiffness, and dizziness, are also commonly caused by active perilymphatic fistulas. This article discusses the typical history and diagnostic tests for patients with perilymphatic fistula. Common diagnostic tests include audiograms, electronystagmograms, electrocochleograms, and subjective and platform fistula tests. Also, the surgical treatment for the perilymphatic fistula (ie, repair of the oval and round windows) is reviewed, along with the results produced by this relatively minor ear operation. Suggestions are made to help the medical professionals involved in rehabilitative care to be aware of perilymphatic fistulas and seek proper consultations from inner ear specialists if they suspect the existence of this easily cured disorder.
越来越多的证据支持这样一种观点，即持续数月甚至数年的头晕可能是由未被察觉的外淋巴瘘引起的。外淋巴瘘是一种异常破裂，使外淋巴从内耳漏入中耳腔。最常见的情况是，这些破裂继发于创伤性事件。脑震荡后综合征一词已被用于描述头部创伤后的一系列症状。其中一些症状，如认知改变、耳鸣、颈部僵硬和头晕，也通常由活跃的外淋巴瘘引起。本文讨论了外淋巴瘘患者的典型病史和诊断测试。常见的诊断测试包括听力图、眼震电图、耳蜗电图以及主观和平台瘘管测试。此外，还对外淋巴瘘的手术治疗（即椭圆窗和圆窗修复）进行了综述，并介绍了这种相对较小的耳部手术的结果。文中提出了一些建议，以帮助参与康复护理的医疗专业人员了解外淋巴瘘，并在怀疑存在这种易于治愈的疾病时向内耳专家寻求适当的咨询。
