외상성 외임파 누공

Perilymphatic fistula(PLF) is one clinical manifestation of inner ear disease, in which fluid leaks from the inner ear to the middle ear cavity. Its symptoms are those of a cochlear lesion and/or vestibular lesion, depending on the affected region.

PLF occurs in a patient after various trauma-lifting, straining, coughing or other vigorous activities, barotrauma, stapedectomy and perilymphatic hypertension etc.

The diagnosis is easy when the injury result from an abrupt pressure change within the middle ear space, for instance, from changes in atmospheric pressure, scuba diving accidents, and slap injuries to the external auditory canal. However, PLF can also occur with much less severe trauma or may occur spontaneously, making the diagnosis much more difficult to estabilish. Unfortunately, there is no diagnostic test pathognomonic for PLF short of exploratory tympanotomy, and even this may not be totally reliable because some fistulas can leak intermittently.

Therefore, absolute criteria for exploration of the middle ear do not exist. Exploration of the middle ear is indicated in patients who have a progressive sensorineural loss or in whom the hearing loss is stable but vestibular symptoms continue despite conservative therapy. The authors experienced 3 cases of PLF associated with various trauma. The purpose of this paper is to represent 3 cases with the review of pertinent literature,