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07/07/2010 12:57 PM

Perilymph Fistula..DIZZY/VESTIBULAR

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Perilymph Fistula..DIZZY/VESTIBULAR

A perilymph fistula is a tear or defect in the oval window and/or the round window, the small, thin membranes that separate the middle ear from the fluid-filled inner ear.

When a fistula is present, changes in middle ear pressure will directly affect the inner ear, stimulating the balance and/or hearing structures and causing symptoms.

The symptoms of perilymph fistula may include dizziness, vertigo, imbalance, nausea, and vomiting. Some people experience ringing or fullness in the ears, and many notice a hearing loss.

Most people with fistulas find that their symptoms get worse with changes in altitude (elevators, airplanes, travel over mountain passes) or air pressure (weather changes), as well as with exertion and activity.

Head trauma is the most common cause of fistulas.

Fistulas may also develop after rapid or profound changes in intracranial or atmospheric pressure, such as may occur with SCUBA diving, aerobatic maneuvers in airplanes, weightlifting, or childbirth.

Fistulas may be present from birth or may result from chronic, severe ear infections. Rarely, they appear to occur spontaneously.

History, physical examination, and vestibular and audiometric test results are used to assist in establishing the diagnosis of perilymph fistula.

However, the only positive way the diagnosis can be confirmed is by performing a tympanotomy (operation) and directly viewing the area of the suspected fistula.

In many cases, a fistula will heal itself with strict bed rest, to give the fistula a chance to close.

If symptoms are severe and have not responded to bed rest, or if progressive hearing loss has occurred, surgical repair of the fistulas may be required.

© 2010 VEDA ·

This document was last modified June 14, 2010, 10:37 am


07/28/2010 11:42 PM
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ongoing DIZZY articles

Device combats common cause of vertigo

URL of this page: fullstory_101447.html (*this news item will not be available after 10/21/2010)

Friday, July 23, 2010

By Dave Levitan

NEW YORK (Reuters Health) -

A new device lets people treat a common cause of dizziness in the comfort of their own home, Canadian researchers say.

So-called "benign paroxysmal positional vertigo" (BPPV) affects roughly 10 percent of the population over age 60, according to studies done in the late 1980s.

It is characterized by intense vertigo (room spinning), which often occurs when looking up, rolling over in bed, or bending under things.

BPPV results from the build-up of crystals in the inner ear.

Doctors typically treat BPPV with a physical maneuver to shift the crystals out of a canal in the inner ear where they cause the feeling of dizziness.

The so-called "Epley" maneuver is fairly simple and highly effective -- but difficult for patients to remember how to do on their own.

So Dr. Matthew Bromwich and colleagues at Children's Hospital of Eastern Ontario in Canada developed a device to help them.

The device, which attaches to the brim of any common baseball cap, is called the DizzyFIX and costs $150.

Bromwich is now the CEO of the company that manufactures it, Clearwater Clinical Limited, but he told Reuters Health that his financial involvement began only after the present study was completed.

The device consists of a plastic tube that attaches to the hat in a way that makes it visible to the person wearing it.

The tube contains a thick fluid and a particle. As the patient moves, the particle moves too, giving visual feedback.

The user simply guides the particle through the device to relieve their dizziness.

"The tube shape was designed to enable accurate replication of the Epley maneuver," say the researchers.

The particle will only move ahead if the patient performs the maneuver correctly.

In their study, published in the Archives of Otolaryngology Head & Neck Surgery, the researchers gave the DizzyFIX to 40 patients suffering from BPPV.

After one week of home treatment, 35 patients (88 percent) had no evidence of BPPV.

There were no serious complications.

The researchers did not include a group of patients with BPPV who did not use the device, but the findings compare "very well to physician-guided treatment for BPPV," Bromwich told Reuters Health by e-mail.

In a follow-up phone interview, he added that BPPV often recurs, both after home treatment with the new device and after physician-guided treatment.

"Recurrence is about 60 percent," he said. "(The device) cures BPPV about as much as Tylenol cures a headache.

The only difference (between the device and physician treatment) is that when you get a recurrence you just reach under the bed, pull out the DizzyFIX, put it on your head, and two and a half minutes later you're cured and you go back to sleep."

The DizzyFIX is approved by the FDA for use with a prescription in the U.S.

It's also approved for use in Europe and Canada.


Archives of Otolaryngology, Head & Neck Surgery, July 2010.

Reuters Health

(c) Copyright Thomson Reuters 2010.

Dizziness and Vertigo:

Medical Device Safety:

Page last updated on 26 July 2010 fullstory_101447.html


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