Peculiarities of differential diagnostics of perilymphatic fistulas of the labyrinth windows of non-inflammatory genesis

Egorov V.I.; Ryazantsev S.V.; Kozarenko A.V.; Lilenko S.V.; Kozarenko M.A.; Pol’schikova A.Yu.

doi:https://doi.org/10.17116/otorino20218604117

Egorov V.I.

Moscow Regional Clinical Research Institute named after M.F. Vladimirsky

Ryazantsev S.V.

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Kozarenko A.V.

Moscow Regional Scientific Research Clinical Institute MF Vladimirsky

Lilenko S.V.

Saint Petersburg ENT and Speech Research Institute;
North-Western State Medical University named after I.I. Mechnikov

SPIN RSCI: 2295-2550
Scopus AuthorID: 6602879929
ResearcherID: O-8264-2014
ORCID: 0000-0001-9858-5219

Kozarenko M.A.

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Pol’schikova A.Yu.

Moscow Regional Scientific Research Clinical Institute MF Vladimirsky

Peculiarities of differential diagnostics of perilymphatic fistulas of the labyrinth windows of non-inflammatory genesis

Authors:

Egorov V.I., Ryazantsev S.V., Kozarenko A.V., Lilenko S.V., Kozarenko M.A., Pol’schikova A.Yu.

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Journal: Russian Bulletin of Otorhinolaryngology. 2021;86(4): 17‑22

DOI: 10.17116/otorino20218604117

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To cite this article:

Egorov VI, Ryazantsev SV, Kozarenko AV, Lilenko SV, Kozarenko MA, Pol’schikova AYu. Peculiarities of differential diagnostics of perilymphatic fistulas of the labyrinth windows of non-inflammatory genesis. Russian Bulletin of Otorhinolaryngology. 2021;86(4):17‑22. (In Russ.)
https://doi.org/10.17116/otorino20218604117

Подписка 2026 Вестник оториноларингологии (Russian Bulletin of Otorhinolaryngology)

Использование инфографики авторами научных работ

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Abstract:

THE PURPOSE OF THE STUDY

To determine the value of the results of various audiological and vestibulometric studies for the differential diagnosis of non-inflammatory perilymphatic fistulas of the labyrinth windows (PFOLW).

MATERIAL AND METHODS

The retrospective and prospective analysis of the informative value of the results of audiological and vestibulometric studies was carried out in 124 people with different combinations of cochleovestibular complaints, who had different pathology of the inner and middle ear, with different terms of the disease — from several days to 30 years. To assess the informativeness of the applied testing, the following operational characteristics were determined: general sensitivity (Se), specificity (Sp) and the prognostic value of a positive result (PPV=positive predictive value). A pair-by-pair comparison of the prognostic value of a positive result of vestibulometric and audiometric tests was performed using the Pearson criterion χ2 and the exact Fisher criterion.

RESULTS

It is shown that none of the tests used has 100% reliability, but the consistent application of some of them can successfully improve the diagnosis of idiopathic PFOL. When comparing the results of a number of tests, such as the Fukuda walking test and / or the Babinsky—Weil walking test, audiometric tests with head clone and hyperventilation, the test of fluid injection into the external auditory canal and the test of J. Frasser & L. Flood, it was found that the average prognostic value of a positive result was 87.3%, which is statistically significantly higher than the average result (47.9%) for other samples.

CONCLUSIONS

Correlations of the results of simple vestibulometric and audiometric tests allow us to recommend them to improve the diagnosis of idiopathic perilymphatic fistulas of the labyrinth windows. The possibilities of modern electrophysiological audiological research methods are subject to further study.

Keywords:

perilymphatic fistulas of the labyrinthine windows

audiological tests

predictive value of a positive result

Authors:

Egorov V.I.

Moscow Regional Clinical Research Institute named after M.F. Vladimirsky

Ryazantsev S.V.

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Kozarenko A.V.

Moscow Regional Scientific Research Clinical Institute MF Vladimirsky

Lilenko S.V.

Saint Petersburg ENT and Speech Research Institute;
North-Western State Medical University named after I.I. Mechnikov

SPIN RSCI: 2295-2550
Scopus AuthorID: 6602879929
ResearcherID: O-8264-2014
ORCID: 0000-0001-9858-5219

Kozarenko M.A.

Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech

Pol’schikova A.Yu.

Moscow Regional Scientific Research Clinical Institute MF Vladimirsky

Received:

15.06.2020

Accepted:

18.06.2021

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References:

Foster PK. Autologous intratympanic blood patch for presumed perilymphatic fistulas. The Journal of Laryngology and Otology. 2016;130(12):1158-1161. https://doi.org/10.1017/s0022215116009580
Whitney T, Parnes S. Perilymph Fistulae: An Uncommon Cause of Dizziness. Global Journal of Otolaryngology. 2017;8(3):1-4. https://doi.org/10.19080/gjo.2017.08.555738
Kryukov AI, Fedorova OK, Antonyan RG, Sheremet AS. Klinicheskie aspekty bolezni Men’era. M.: OAO «Izdatel’stvo «Medicina»; 2006. (In Russ.).
Kryukov AI, Kunel’skaya NL, Garov EV, Zelikovich EI, Fedorova OV, Krasnikova DI. Diagnosis and treatment of Minor syndrome. Vestnik otorinolaringologii. 2012;5:8-13. (In Russ.).
Kunel’skaya NL, Garov EV, Sheremet AS, Bajbakova EV, Fedorova OV, Garova EE, Sudarev PA, Azarov PV, Akmuldieva NR. Options for surgical treatment and its results in patients with peripheral vertigo of various origins. Medicinskij sovet. 2013;7:48-52. (In Russ.).
Kunel’skaya NL, Fedorova OV, Zagorskaya EE, Bajbakova EV. Kliniko-diagnosticheskie kriterii fistul okon labirinta i bolezni Men’era. Materialy XIV nauchno-prakticheskoj konferencii «Farmakologicheskie i fizicheskie metody lecheniya v otorinolaringologii». M. 2016. (In Russ.).
Egorov VI. Kohleo-vestibulyarnye rasstrojstva: perilimfaticheskie fistuly labirinta (klinika, diagnostika, lechenie: Dis. ... kand. med. nauk. SPb. 2000. (In Russ.).
Patyakina OK, Yanov YuK, Egorov VI. Perilimfaticheskie fistuly labirinta. M.: Nauka; 2000. (In Russ.).
Nagai T, Nagai M. Labyrinthine window rupture as a cause of acute sensorineural hearing loss. European Archives of Oto-Rhino-Laryngology. 2012;269(1):67-71. https://doi.org/10.1007/s00405-011-1584-0
Prenzler NK, Schwab B, Kaplan DM, El-Saied S. The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula. American Journal of Otolaryngology. 2018;39(1):46-49. https://doi.org/10.1016/j.amjoto.2017.10.006
Tabuchi K, Murashita H, Okubo H, Takahashi K, Wada T, Hara A. Preoperative evaluation of ossicular chain abnormality in patients with conductive deafness without perforation of the tympanic membrane. Archives of Otolaryngology — Head and Neck Surgery. 2005;131(8):686-689. https://doi.org/10.1001/archotol.131.8.686
Flood LM, Fraser JG, Hazell JW, Rothera MP. Perilymph fistula. Four year experience with a new audiometric test. The Journal of Laryngology and Otology. 1985;99(7):671-676.
Kozarenko MA. Diagnostics of non-inflammatory perilymphatic fistulas of labyrinth windows. Nauka i innovacii v medicine. 2018;9(1):55-58. (In Russ.).
Loong T-W. Understanding sensitivity and specificity with the right side of the brain. British Medical Journal (Clinical Research Edition). 2003;327(7417):716-719. https://doi.org/10.1136/bmj.327.7417.716
Fang JQ. Handbook of Medical Statistics. Singapore: World Scientific; 2018. https://doi.org/10.1142/10259