WordNet

an abnormal passage leading from a suppurating cavity to the body surface (同)sinus

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瘻(ろう)菅(長い菅状になった潰瘍)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/30 21:49:08」(JST)

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A labyrinthine fistula is an abnormal opening in the bony capsule of the inner ear, resulting in leakage of the perilymph from the semicircular canals into the middle ear.^[1] This includes specifically a perilymph fistula (PLF), an abnormal connection between the fluid of the inner ear and the air-filled middle ear. This connection is caused by a rupture of the oval window or round window that separate the inner and middle ear.^[1] Another type of l.f. is a semicircular canal dehiscence, which allows the inner ear to be influenced by the intracranial pressure directly.

Cause[edit]

These can be both congenital or develop over time with the thinning of the otic capsule by the persistent pulsations of the intracranial pressures against the bones of the skull. Finally, disease conditions—for example cholesteatoma—can result in a labyrinthine fistula.^[2] Traumatic events, with excessive pressure changes to the inner ear such as in scuba diving,^[3] head trauma, or an extremely loud noise can lead to rupture and leakage.^[1]

Signs and symptoms[edit]

PLF is a cause of dizziness, imbalance, and hearing loss—any or all of these symptoms can exist. Vertigo (an illusion of motion) is not common in this disorder. The most common cause of this fistula is head or ear trauma. Rapid increases of intracranial pressure can also result in a PLF. Rarely, these fistulas can be congenital, leading to progressive hearing loss and vertigo in childhood. It has also been a complication of a stapedectomy.

Diagnosis[edit]

When diagnosing, PLF should be differentiated from Ménière's disease. Tympanostomy has been reported to be a way to diagnose^[4] and cure PLF.

Treatment[edit]

Patients are advised to treat with bed rest and avoiding activities that increase intracranial pressure (i.e. weightlifting, valsalva, scuba diving, flying in airplanes) with the hopes of the membrane healing on their own. Appropriate Physical therapy / vestibular rehabilitation techniques can be helpful in managing symptoms of movement sensitivity.^[1]

References[edit]

^ ^a ^b ^c ^d O'Sullivan, Susan B. (2007). Physical Rehabilitation (Fifth ed.). Philadelphia: Davis Company. p. 1024.
^ Chen Z, Wu Y, Shi H, et al. (June 2009). "Surgical treatment of labyrinthine fistula caused by cholesteatoma with semicircular canal occlusion". Acta Otolaryngol.: 1–4. doi:10.1080/00016480902875083. PMID 19488888.
^ Donoghue, P; Knight, J. "The causation of perilymph fistulae in divers.". Journal of the South Pacific Underwater Medicine Society 10 (2): 13–14. Retrieved 2013-09-22.
^ Goto F, Ogawa K, Kunihiro T, Kurashima K, Kobayashi H, Kanzaki J (January 2001). "Perilymph fistula--45 case analysis". Auris Nasus Larynx 28 (1): 29–33. doi:10.1016/S0385-8146(00)00089-4. PMID 11137360.

External links[edit]

http://www.dizziness-and-balance.com/disorders/unilat/fistula.html

UpToDate Contents

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1. 回転性めまいの病態生理、病因、および鑑別診断 pathophysiology etiology and differential diagnosis of vertigo
2. 耳圧外傷 ear barotrauma
3. 中耳外傷の評価およびマネージメント evaluation and management of middle ear trauma
4. 回転性めまい患者の評価 evaluation of the patient with vertigo
5. 成人における難聴の病因 etiology of hearing loss in adults

English Journal

Curved Adjustable Fiberoptic Laser for Endoscopic Cholesteatoma Surgery.

Yau AY1, Mahboubi H, Maducdoc M, Ghavami Y, Djalilian HR.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.Otol Neurotol.2014 Sep 26. [Epub ahead of print]
OBJECTIVE: To determine whether endoscopic cholesteatoma removal can be performed efficiently and safely using a curved fiberoptic-based laser.BACKGROUND: Angled instruments are required in endoscopic ear surgery to access recesses of the middle ear without extra drilling. Lasers are effective at ab
PMID 25279936

Trauma-associated tinnitus.

Kreuzer PM1, Landgrebe M, Vielsmeier V, Kleinjung T, De Ridder D, Langguth B.
The Journal of head trauma rehabilitation.J Head Trauma Rehabil.2014 Sep-Oct;29(5):432-42. doi: 10.1097/HTR.0b013e31829d3129.
BACKGROUND: Up to 53% of individuals suffering from traumatic brain injuries develop tinnitus.OBJECTIVE: To review the current literature on trauma-associated tinnitus in order to provide orientation for the clinical management of patients with trauma-associated tinnitus.MATERIALS: A systematic lite
PMID 23982788

Imaging of temporal bone trauma.

Kennedy TA1, Avey GD2, Gentry LR2.
Neuroimaging clinics of North America.Neuroimaging Clin N Am.2014 Aug;24(3):467-86, viii. doi: 10.1016/j.nic.2014.03.003. Epub 2014 May 21.
Temporal bone trauma is commonly seen in patients with craniofacial injury and can be detected using multidetector computed tomography. A thorough understanding of the different types of temporal bone fracture patterns is needed to accurately describe the trajectory of injury as well as anticipated
PMID 25086807

Japanese Journal

治療中に聴力の変動, 悪化がみられた急性感音難聴の検討

日本耳鼻咽喉科学会会報 118(3), 201-205, 2015
NAID 130005065315

外リンパ瘻症例の臨床的検討

耳鼻咽喉科展望 57(6), 322-329, 2014
NAID 130005114468

外リンパ瘻からの続発性内リンパ水腫形成を疑った2症例

Equilibrium Research 73(1), 16-21, 2014
NAID 130003395176

Related Pictures

★リンクテーブル★

リンク元	「外リンパ瘻」「PLF」
関連記事	「perilymphatic」

「外リンパ瘻」

Labyrinthine fistula
	Classification and external resources
	; Cross-section of cochlea. Perilymph is located in the scala tympani and scala vestibuli - the aqua regions at the top and bottom of the diagram.
ICD-10	H83.1
ICD-9	386.4
DiseasesDB	32218
eMedicine	emerg/414

　　[★]

英: perilymphatic fistula, perilymph fistula
関: 内耳窓破裂
関: 外リンパ液、内リンパ液

概念

外的・内的な圧力が内耳にかかり、前庭窓もしくは蝸牛窓の破綻を来たして内耳症状をきたしたもの

病因

explosive route：脊髄圧の急激な上昇(力む、咳き込む、鼻をかむなど)
implosive route：内耳圧の急激な上昇(Valsalva法、気圧性外傷など)

徴候

瘻孔現象
Tullio現象

症状

難聴、耳鳴、耳閉塞感、めまい、平衡感覚障害。

治療

ベットでの安静、頭部挙上、および力むことを回避する。数週間の保存療法で回復しなければ外科手術により瘻孔にパッチを当てる。(参考1)

予後

再発率は10%である。 (参考1)

参考

1. [charged] Pathophysiology, etiology, and differential diagnosis of vertigo - uptodate [1]

「PLF」

　　[★]

「perilymphatic」

　　[★]

外リンパの

関: perilymph

[O.27Sullivan_2007_1024-1] O'Sullivan, Susan B. (2007). Physical Rehabilitation (Fifth ed.). Philadelphia: Davis Company. p. 1024.

[pmid19488888-2] Chen Z, Wu Y, Shi H, et al. (June 2009). "Surgical treatment of labyrinthine fistula caused by cholesteatoma with semicircular canal occlusion". Acta Otolaryngol.: 1–4. doi:10.1080/00016480902875083. PMID 19488888.

[RRR10266-3] Donoghue, P; Knight, J. "The causation of perilymph fistulae in divers.". Journal of the South Pacific Underwater Medicine Society 10 (2): 13–14. Retrieved 2013-09-22.

[pmid11137360-4] Goto F, Ogawa K, Kunihiro T, Kurashima K, Kobayashi H, Kanzaki J (January 2001). "Perilymph fistula--45 case analysis". Auris Nasus Larynx 28 (1): 29–33. doi:10.1016/S0385-8146(00)00089-4. PMID 11137360.

匿名

検索

案内

案内

perilymphatic fistula