Choi et al reported criteria for the diagnosis of barotraumatic perilymph fistula (PLF). The authors are from Samsung Medical Center and Sungkyunkwan University in Seoul.
Barotraumatic perilymphaitc fistula involves an abnormal communication between the perilymphatic space of the inner ear and the middle ear cavity, either through the round or oval windows.
Criteria for a diagnosis of probable PLF - all of the following:
(1) preceding history of barotrauma
(2) sudden onset of auditory symptoms (tinnitus, sense of ear fullness, and/or sensorineural hearing loss)
(3) dizzness with one or more of the following features:
(3a) dizziness aggravated by positional change
(3b) time difference between the onset of auditory symptoms and dizziness
(3c) positional nystagmus (multi-directional positional nystagmus, small amplitude of long duration and with no reversibility, no response to otolith repositioning maneuver)
where:
• Testing for positional nystagmus includes the Dix-Hallpike test and supine head roll test.
A definitive diagnosis of PLF - both of the following:
(1) criteria met for probable PLF
(2) visual confirmation of perilymph leak through round or oval windows (usually at surgical exploration)
