Head trauma causing perilymphatic fistula

Objective Head trauma can be classified into four groups in terms of its central affection from concussion to traumatic brain injury (TBI) Grade I to III. The affection of the labyrinthine receptors by head trauma is known and can affect the cochlea, the semicircular canals and the otolith organs. So far temporal or permanent structural lesions by a concussion of the labyrinth are assumed to be the underlying mechanism of functional impairment. Rarely temporal bone fractures are observed. Cochlin tomoprotein ELISA allows for the first time an objective evaluation of a perilympatic fistula by a microfracture or lesion of the round or oval window. The aim of this study was to evaluate the occurrence of perilympatic fistula in patients with minor head trauma.

Methods In a prospective study of 53 patients with sudden hearing loss the cause of hearing loss was evaluated in the affected patients group. Hearing loss and vestibular receptor function was observed.

Results The anamnestic cause for hearing loss could be estimated in 21 patients. In 7 out of 21 patients a head concussion could be directly associated with the labyrinthine receptor function impairment. In 5 out of 7 hearing loss was associated with an ipsilateral vestibular receptor function loss (cVEMP, caloric function). In 5 out of 7 patients a perilymphatic fistula could be confirmed by CTP ELISA.

Conclusion Minor head trauma is frequently accountable for hearing loss. Perilymphatic fistula occur frequently in minor head trauma with hearing loss and vertigo (labyrinthine concussion).

Publication History

Article published online:
12 May 2023