Perilymph Fistula in Emergency Medicine Follow-up
- Author: Nancy E Conroy, MD; Chief Editor: Rick Kulkarni, MD more...
Further Inpatient Care
- Bedrest with the head of the bed elevated to 30°
- Avoidance of lifting or pressure-increasing activities (ie, Valsalva maneuver)
- Surgical intervention is the principle approach to treatment when perilymph fistula is diagnosed. The site of perilymph leak is covered with some form of autologous tissue.
Further Outpatient Care
- Strict bedrest for 5-7 days or until reevaluation
- Elevation of the patient's head above the heart level
- Avoidance of straining
- Avoidance of nose blowing or Valsalva maneuver
- No lifting (>10 lb)
- Stool softeners
Complications
- Both the patient and the physician should be prepared for no response to treatment, especially with regard to hearing improvement. Recurrence of postoperative signs and symptoms may occur in 21-47% of patients.
- Perilymph fistula may be associated with recurrent meningitis in children.
Prognosis
- Because of the difficulty in making the diagnosis of perilymph fistula, the natural history of this disorder is unknown.
- Significant improvement in symptoms that are presumed to be from perilymph fistula may occur with conservative treatment.
- Surgery is more successful in relieving vertiginous symptoms than in improving hearing.
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