Spinal fluid-perilymph relationships in patients with vertigo, tinnitus, pressure and hearing fluctuation
Abstract
Over the last 28 years the author has been fascinated with both Meniere’s disease and patients with perilymphatic fistula (PLF), two conditions which at times closely resemble each other and at times may be indistinguishable. Both conditions manifest themselves with vertigo, tinnitus, pressure or fullness and hearing fluctuation or loss. All of these entities may not be present in each case. Usually but not always there is an obvious “event” which precedes the condition of PLF. Several cases of recurrent PLF after a successful PLF repair have lead the author to perform lumbar puncture on them. As a result he has made the diagnosis of pseudotumor cerebri in eight cases and learned that removal of spinal fluid whether normal or elevated has the potential of rendering patients with an active PLF immediately asymptomatic for a period of hours to months. Therapy ranges from simple oval and round window reinforcement to ventriculo-peritoneal shunting. Several cases will be presented.