Further Outpatient Care
See the list below:
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Strict bedrest for 5-7 days or until reevaluation
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Elevation of the patient's head above the heart level
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Avoidance of straining
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Avoidance of nose blowing or Valsalva maneuver
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No lifting (>10 lb)
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Stool softeners
Further Inpatient Care
See the list below:
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Bedrest with the head of the bed elevated to 30°
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Avoidance of lifting or pressure-increasing activities (ie, Valsalva maneuver)
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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.
Complications
See the list below:
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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.
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Perilymph fistula may be associated with recurrent meningitis in children.
Prognosis
See the list below:
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Because of the difficulty in making the diagnosis of perilymph fistula, the natural history of this disorder is unknown.
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Significant improvement in symptoms that are presumed to be from perilymph fistula may occur with conservative treatment.
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Surgery is more successful in relieving vertiginous symptoms than in improving hearing.
