title: Perilymphatic fistula in cabin attendants: an incapacitating consequence of flying with common cold.
abstract: A perilymphatic fistula (PLF) is an abnormal communication between the inner ear and the middle ear that leaks perilymph. PLF is considered rare, but is known to occur during childbirth, straining, weightlifting, head trauma, and diving with middle ear equalizing problems. It has also, anecdotally, been described in connection with flying. The symptoms are uncharacteristic vertigo and, in some cases, hearing impairment and tinnitus. This study describes four cases of PLF during a period of 6 mo in a major Scandinavian airline company employing approximately 3000 cabin attendants (CAs). None of the cases were diagnosed at the primary health care level. All were referred to the Aviation Medical Center for investigation. The PLF diagnosis was based on the case history, Platform Pressure Test (a fistula test), and other vestibular tests. Only one CA has been able to return to flying duties. The article emphasizes the risk of flying with poor middle ear equalization and the necessity of reminding crews and airline companies to "never fly with a common cold".
authors.affiliation: Aviation Medical Center and Department of Otorhinolaryngology, Head and Neck Surgery, FLMKL-7522, Cophenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark. klokker@dadlnet.dk
authors.forename: Mads
authors.initials: M
authors.lastname: Klokker
authors.forename: Søren
authors.initials: S
authors.lastname: Vesterhauge
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D003052:Cochlear Aqueduct; D003139:Common Cold / Q000150:complications*; D004244:Dizziness / Q000209:etiology; D005260:Female; D005402:Fistula / Q000175:diagnosis* / Q000628:therapy; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D014012:Tinnitus / Q000209:etiology; D014724:Vestibular Function Tests