title: Traumatic perilymphatic fistula with pneumolabyrinth: diagnosis and management.
abstract: A perilymphatic fistula (PLF) is an abnormal communication between the inner and middle ear resulting in vestibular or cochlear symptoms. We review three pediatric traumatic temporal bone fractures with pneumolabyrinth, confirmed radiologically by the presence of air within the cochlea (pneumocochlea) or vestibule (pneumovestibule). Patients were treated conservatively with complete resolution of vestibulopathy. Hearing outcome was variable and worse in two patients with pneumocochlea. A pneumolabyrinth on radiologic imaging confirms a PLF and obviates the need for exploration to reach a diagnosis. We suggest exploration be reserved for patients with persisting cerebrospinal fluid leakage, progressive sensorineural hearing loss, or vestibular symptomatology.
authors.affiliation: Department of Otolaryngology, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Eitan
authors.initials: E
authors.lastname: Prisman
authors.forename: James D
authors.initials: JD
authors.lastname: Ramsden
authors.forename: Susan
authors.initials: S
authors.lastname: Blaser
authors.forename: Blake
authors.initials: B
authors.lastname: Papsin
mesh_terms: D000293:Adolescent; D000388:Air; D001265:Athletic Injuries / Q000150:complications* / Q000175:diagnosis; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D003052:Cochlear Aqueduct / Q000293:injuries*; D015834:Cochlear Diseases / Q000175:diagnosis* / Q000534:rehabilitation; D003638:Deafness / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation; D004432:Ear, Middle / Q000293:injuries*; D005402:Fistula / Q000175:diagnosis* / Q000534:rehabilitation; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries*; D005624:Frontal Bone / Q000293:injuries*; D016489:Head Injuries, Closed / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007759:Labyrinth Diseases / Q000175:diagnosis* / Q000534:rehabilitation; D008297:Male; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis; D013701:Temporal Bone / Q000293:injuries*; D036542:Tomography, Spiral Computed; D014722:Vestibule, Labyrinth / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000534:rehabilitation