title: Repair of a cerebrospinal fluid perilymph fistula primarily through the middle ear and secondarily by occluding the cochlear aqueduct.
abstract: A 35-year-old man had a 5-year history of fluctuating hearing loss in his only hearing ear. History and diagnostic tests indicated a perilymph fistula, a diagnosis subsequently confirmed by exploration. Primary and secondary repairs temporarily ameliorated symptoms. A spinal fluid to middle ear fluid pathway was identified by radioactive tracer. A patent cochlear aqueduct indicated on computed tomography scan was found and repaired through a posterior cranial fossa approach. Hearing was preserved, remaining relatively stable during the 2-year follow-up period.
authors.affiliation: Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
authors.forename: D J
authors.initials: DJ
authors.lastname: Weider
authors.forename: R L
authors.initials: RL
authors.lastname: Saunders
authors.forename: F E
authors.initials: FE
authors.lastname: Musiek
mesh_terms: D000328:Adult; D002558:Cerebrospinal Fluid Otorrhea / Q000150:complications / Q000601:surgery*; D003052:Cochlear Aqueduct / Q000000981:diagnostic imaging / Q000601:surgery*; D005402:Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008722:Methods; D010046:Oval Window, Ear / Q000601:surgery; D010498:Perilymph; D011859:Radiography; D012008:Recurrence; D012405:Round Window, Ear / Q000601:surgery