title: Diagnostic criteria of barotraumatic perilymph fistula based on clinical manifestations.
abstract: CONCLUSIONS
  Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF.
  
  
  OBJECTIVE
  The aim of this study was to establish diagnostic criteria for barotraumatic PLF.
  
  
  METHODS
  Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF. The causes of barotrauma and clinical symptoms were analyzed by surgical findings. Diagnostic criteria of PLF were proposed according to its clinical manifestations.
  
  
  RESULTS
  Definite PLF (17 subjects) was confirmed by any evidence of perilymph leak through oval and round windows. For the other seven subjects (probable PLF), even though there was no evidence of perilymph leak, their clinical manifestations were similar to definite PLF. High frequency hearing loss occurred as an early symptom after barotrauma. Positional dizziness occurred a few hours after auditory symptoms (67%). Positional nystagmus was observed in 10 cases. The characteristics of positional nystagmus were multi-directional, longer in duration, smaller in amplitude, no reversibility, and no response to repositioning maneuver. Regarding the surgical outcomes, hearing was significantly improved in the early repaired PFL group, and dizziness was improved in 96% of patients.
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Ji Eun
authors: JE
authors: Choi
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Il Joon
authors: IJ
authors: Moon
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Hankyeol
authors: H
authors: Kim
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Kieun
authors: K
authors: Lee
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Yang-Sun
authors: YS
authors: Cho
authors: a Department of Otorhinolaryngology -- Head and Neck Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea.
authors: Won-Ho
authors: WH
authors: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D001469:Barotrauma / Q000150:complications*; D004423:Ear / Q000293:injuries*; D004427:Ear Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010498:Perilymph; D012189:Retrospective Studies; D055815:Young Adult
keywords: Barotrauma; perilymph fistula; positional nystagmus; sudden sensorineural hearing loss