Perilymph Fistula - Surgery Or Not?
Sep 28, 2014
To cut a long story short - mid August 2014 I did a sinus rinse for chronically blocked sinuses. It went very wrong and I ended up with water trapped in my left middle ear. It didn't come out by itself and the pain and pressure was getting too much. I saw a GP and we agreed on using a nasal balloon to equalise the ears and try to get the water out. I also tried a few valsalva actions.
One day (first week of September), I was using the balloon when I felt a painful loud click in my right ear. This is where my real problems started.
I now deal with: constant tinnitus in right ear, dizziness, vertigo, some nausea, really bad head pressure, auras, vibrations and buzzy feelings throughout body, deep pain in ear - can almost feel blood or fluid in right ear.
Saw GP and it is a suspected Perilymph Fistula of the round window in the inner ear. I am seeing an ENT privately, hopefully in the next 2 weeks. Thing is, I am in England, UK and I am worried that they don't really deal with PLFs. Then I will be stuffed!
I am currently doing as much bed rest as I can as I read online this is best at this stage. I am however very very worried about what has happened. I am worried about leaking CSF fluid too. I certainly have enough head pressure.
Can this really heal with bed rest or do I need surgery? Also, I am scared about my tinnitus getting worse with surgery. Anyone who has had PLF repair surgery, what was the outcome? Did your tinnitus get worse or better in the end? Did the head pressure go? Has anyone recovered just with bed rest?
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Anyone out there had this surgery? I'm in week 3 and wondering what to expect going forward.
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My story is as follows: about a month ago, I began having ear pain that would alternate between ears. After a few days of this, the pain settled in my right ear, where I developed both pain and fullness that persisted for about two weeks. My ear constantly had the sensation that it needed to "pop," such as what one experiences when on an airplane. I went to my GP after a week of these sensations, who told me that it was likely Eustachian Tube Dysfunction and that it would resolve soon. She prescribed decongestants, antihistamines, and a steroid nasal spray. I took Sudafed and Allegra (but not the spray, as I am scared of steroids) but they did not seem to help.
Well, in the meantime, my blocked ear was annoying the crap out of me, so I decided to go online and look for some home remedies to try. One thing that I found was something called the Valsalva maneuver, in which you close your mouth, pinch your nose and blow out against closed airways to unblock the ear. I tried this several times over the course of a few days in attempts to get my ear to unblock. Most times it was difficult to get the right ear to "pop," and even when it did, it did not alleviate my symptoms.
Shortly after trying this maneuver, however, I read that the Valsalva maneuver can actually DAMAGE your inner ear and cause a perilymph fistula if done too forcefully. (I don't think I did it too forcefully, but I can't be sure.) Learning this sent me into a panic, and ever since, I have been experiencing a vague, constant dizziness that lasts all day. I have had trouble focusing my eyes and it feels, at times, like my brain is being sucked up and out of my skull (sorry). In the meantime, the sensation of fullness and pain in my right ear has improved greatly, but I am still being plagued by this constant dizziness. This dizziness has been present for a full week now. I have no sensitivity to loud noises, no hearing loss, and no episodes of vertigo. I do have a bit of wooziness when I am a passenger in a car, and I have felt extremely, unnaturally ill and fatigued throughout this ordeal. For those of you who have had PLF, does this sound like it could be a possible PLF? Is it even likely that I acquired a PLF after performing the Valsalva Maneuver?
Thank you so much for your help. I am hoping and praying that this dizziness is a fluke and not related to a PLF or inner ear damage, but the possibility scares the ****** out of me, regardless. I have had an extremely stressful year between losing my job, acquiring a crippling hip injury, and dealing with a host of other health issues, and the possibility of chronic dizziness is not something I feel capable of dealing with at this point.
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I am going through a possible plf and trying to talk to people who know about these. Please if you are still around I'd love to talk. There are very few people out there and. Very little information.
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I was hoping for some advice on a problem that I've had for 3 years. My main problem has been on and off vertigo and imbalance, however I don't think I have rotational vertigo because most of the time I just feel like inside my head is spinning? It also feels as if the ground is sinking beneath me.
Dizziness started 3 years ago, about 2 months after a serious bout of the flu which took months to recover from. At the time my ears were extremely blocked and I would do the Valsalva maneuver to help unclog my ears. It wasn't until now that I discovered you aren't supposed to do that? Anyway my dizziness was consistent 24/7 for nearly 1 year, at which time my symptoms seemed to disappear. As of April this year my symptoms returned.
Over the years I have been to numerous GP's, ENT's, neurologist, and all of which were unsure of what was going on. Most of them have said they don't believe it's Meniere's disease. My main GP said I DIDN'T have fluid in my middle ears, however since then 2 GP's have both confirmed that I DO.
Current symptoms:
Brain fog
Dizziness/vertigo
My ears feel wet in the morning. Not enough to wet pillow
Tinnitus in both ears, slightly more prominent on the left side
Fatigue
Difficulty concentrating/problems with memory
Tingling/electric shock feeling on left side of scalp behind left ear
Anxiety
GERD and gastritis
A couple of things seem to exacerbate these symptoms, such as anxiety, hot and humid weather, having a hot shower (I now have to have cold showers, before I would have to sit down), menstrual cycle.
So I am pretty convinced that I either have a perilymph fistula or middle ear fluid. I have been using Nasonex for a couple of months which seemed to improve symptoms but now I am starting to feel worse again. My now current GP has suggested Ventilation tubes/grommets, however if I actually have a perilymph fistula will this improve symptoms or not have any benefit at all? I also have been prescribed SERC but I do not think it will help, as 2 years ago I took it and it made my symptoms WORSE.
I am wondering if I may have damaged my ears years ago when I had the flu by constantly trying to pop my ears. I have been allergy tested for Molds, grass, pet dander and dust mites, all negative. I have also been tested for MS which was negative, and all the routine blood tests etc. MRI showed I have a mid-septal deviation (my nose isn't straight) and previously enlarged adenoids, but apparently was of no clinical significance.
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In the spring of 1990 after a chronic right middle ear infection, I began having bad vertigo, nausea, and disequilibrium problems. I saw the ENT recommended by my PCP and after testing that came back normal was scheduled for exploratory surgery. A perilymph fistula was visualized and patched. Recovery was normal with some slight dizziness continuing for a few months and then resolving. Postoperative testing revealed no loss of hearing from the surgery and I was released from care to resume normal life.
Fast forward to March 2014, severe disequilibrium, tinnitus, and noticeable hearing loss brought me back to the same ENT (A relief, as he remembers me as being his only visually confirmed PLF) Testing showed hearing in the right ear normal but not as good as the unaffected left ear, other testing showed a possible recurrence of a PLF in the the same ear (right). I am scheduled for surgery on April 30, 2014.
There was nothing during this time that would account for the fistula to recur, no heavy lifting, head trauma, air travel, upper respiratory illness, etc. He feels that I may have a predisposition to increased pressure in my inner ear that causes the fistula to recur. Has anyone heard of this? And, if so, why would it take 24 years to happen again?
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Though I am actually considering that I have something called basilar migraines, which in many ways can mimic fistulas, I want to make sure that there is no chance of small bilateral fistulas in my ears.
Essentially, I have had progressive hearing loss for 11 months now, along with a number of other symptoms that began to flare up in August. I have a history of 3 separate acoustic traumas that occurred earlier last year, and I have heard that under extraordinary circumstances acoustic traumas can cause fistulas at the oval window.
My triggers have included loudish noise above 80 decibels, middle ear pressure changes from flying on an airplane or wearing earplugs, strenuous exercise, lifting heavy objects, and clenching my teeth too hard at one point (I was angry).
Most times when I have an extended exposure to any of these factors, I am usually left with a small degree of permanent bilateral hearing loss. I am also often left with dizziness/imbalance symptoms, rocking boat vertigo, roaring or very high pitched tinnitus, parathesia in my hands and feet, pressure headaches that start at the temples and migrate to the sinuses, pressure behind my eyes and occasional aura, hyperacusis, middle ear myoclonus (muscle fluttering), feelings of cold liquid deep in my ears, and on a few occasions, a fuzzy lightheaded feeling that makes me feel I am going to pass out.
Many of these symptoms resolve, but some, like the vertigo and ear fullness, often stay around long term and present in daily episodes.
Do these sound like familiar symptoms to anyone who has (or has had) a PLF? Please do let me know of any similar experiences! Am on the verge of needing hearing aids, so I am trying to get to the root of the problem as soon as possible.
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Around ten years ago I was the victim of a violent crime in which the back of my head hit the cement hard enough to crack the base of my skull in which the doctors said I had brain fluid leaking and caused black eyes, and cause me to lose consciousness. At the time blood was leaking out of my left year. For months after the injury I was very dizzy, ears feel full,had terrible tinnitus and have lost hearing in my left ear only. Eventually the dizziness went away but not the hearing loss or tinnitus. Since the injury I will have times when I "trigger" these same symptoms I had directly after my head injury. If I for example run, jog, look up or down for long periods of times, cough hard, sneeze hard, or basically jar by body in any way. I've been to many doctors who have prescribed many medications mostly to treat migraines and have also been told that they believe it is migraines. Nothing has ever worked. Bed rest and keeping still seems to be the only thing that helps but can take anywhere from a day, to a month to be able to function without symptoms again. This is ruining my life and my career is suffering. I seem to forget things easy and have trouble focusing which was never a problem before my injury. I am ready to be over this and have my life back. Please, anyone with any suggestions or have had these symptoms please help me. Oh and I've also had a few MRIs over these 10 years to rule out brain injuries and Acoustic Neuroma which all came back negative. There are more symptoms not as consistent but these are the usual when I have an "episode.
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I am diagnosed Meniere's but suspecting that I may have Perilymph Fistula....very similar symptoms to Meniere's but cause by trauma-induced leakage of the inner ear.
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What can cause a fistula between the urethra and anus
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I have had a rectal fistula diagnosed via colonoscopy. I have zero problems with it and would not have known I had it. From the operative report:
"midline anal fistula which was superficial with minimal amount of muscle involved within the fistula".
The surgeon said it should be fixed.
Why can't I just leave it alone? Do these ever go away on their own?
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Now 22 , at the age of 13 , i started to have urination difficulties , standing in front of the toilet for about an hour , feeling the urge to urinate even though i know at the same time that my bladder is almost empty and finally a drop or two come , it continued for about a year then it was gone , for the last three years i have been having the habit of excessive masturbation ( sometimes 4 times per day ) , most of the time i go directly into sleep after masturbation , and as result the usual need to urinate after masturbation is suppressed and the urine is retained till i woke whereas i feel its reflux in the ureter , during this period whenever i go to sleep with full bladder ( regardless after masturbation or not ) , the urge to empty my bladder never woke me up , but what came up recently that i started to drink half liter of beer before i go into sleep directly every night for the last 3 days , yesterday i felt my prostate hard as rock , this sensation is mild so far , it is expressed more when i sit on something hard or try to urinate , now today this morning when masturbated after 2 days of cutting masturbation off , this mild sensation became to increase , then afterward masturbation when i try empty my bladder i felt more pain and couldn't pass urine , when i tried about 2 hours later , i managed to do it hardly after i tried to strain my bladder , whereas during these 2 hours i felt urine retention but with much less of the natural urge which drive you to the bathroom but i still feel the pain of reflux at up the ureters , the one thing which is so clear , that my pain is expressed from the prostate as hardening or feeling it like a rock , with mild sensation of burning . Also i think it is important to mention that at the age of 15 i got " pilonidal sinus " and underwent surgery to remove it but , i stopped checking it for the last 5 years and i have been feeling it pain coming back for about a year or more , but i ignored it , whereas i am referring that i may have a case of prostatitis with infection originated from the fistula , i also doubt it may be prostate cancer , even i know the chances of having it at such age is almost nil , this is why i am thinking to take the test of " PSA "
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So I have had an issue with fissures in the past, due to being on pain meds for pancreatitis for months and cooccurrent constipation. I have already had one surgery to heal the fissure, and it seemed to work. So when I started have that same burning pain when I had a BM I assumed that was what it was. I became really used to it, and it went on for a LONG time. Flash forward to now. I noticed a couple weeks back what looked like pus on my toilet paper when I wiped after urinating, and was freaked out. I pushed on the area near my anus and more pus came out. I assumed my fissure got infected somehow and left it alone. It happened again, this time I was home so I grabbed a hand mirror and looked down there. I saw a bloody spot that was leaking blood slowly about 1 inch from my anus, and I freaked out. I had NO idea what it was, so I googled it and looks like it may be a fistula. It seems to "close up" and go away for a while, then I can smell something and when I go the bathroom I am leaking a little bit of blood/pus from the hole. Seems to happen randomly, its opening doesn't seem to have any correlation with when I have a BM and BM's aren't bloody typically. I have been using anti bacterial soap down there frequently now and I can feel what feels like a ridge under the skin running from the hole to my anus if that makes any sense?
I am completely embarrassed. I am 28 years old and a female, someone who doesn't even leave the house without makeup and this situation is so bad. It smells, I feel like I smell 24/7 (nobody has mentioned it but I feel like I do) and I am almost too embarrassed to go to the doctor. Doesn't help that I am overweight, and though I am meticulously clean (I even use a bidet) I feel like somehow the doctor will judge me as a gross fat girl.
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I had a high transsphincteric fistula (multiple abscesses). CRS placed a cutting seton with fistulotomy in July. CRS told me that the seton would be in prob 4-6 weeks. It is now 8 weeks later, new CRS (first one moved), told me that he doesn't use these much as they are not tolerated well and that he thinks he will have to go back in and tighten it as it is not advancing. He says this is/can be a long process. Now I am to go back in several weeks to finalize new plan. Problem is, after surgery, I had Augmentin. The fistula track was not draining like it was supposed to and I got another abscess... after the fistulotomy and seton placement. CRS gave me Augmentin which I'm not sure really helped. So, I got a total body rash from the augmentin. I lasted 5 weeks before I was so miserable that I finally took oral steroids from Dermatologist with CRS approval. After I did two weeks of steroids, which helped tremendously, the rash came right back. Derm subsequently gave me a new prescription for prednisone (for one month taper!) and told me that it is a rebound rash after I stopped steroids. CRS says he won't do next surgery until I am off of prednisone for several weeks. Do I take the prednisone? or try to power thru the rash and not tear off my skin? How long will this next seton take to cut thru? wonder if it will get "stuck" midway too? More tightening procedures? Oh.. what to do?
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My dad went through numerous surgeries regarding a perianal abscess near his groin, after a few surgeries a fistula was developed is that normal?
Another issue he is having now is when he urinates he sees pieces of stool also coming through with the urination, and when he passes gas he sees his inner thigh inflate and at times some stool. His wounds are left open by his surgeon for any pus/bacteria that gets built up to naturally leave the body.
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Two weeks ago I underwent an anal sphincter repair as well as a rectovaginal fistula repair. I had a fourth degree tear at the birth of my second baby 9 months ago and as a result of this needed this surgery. However a small hole appeared to one side of my back passage and I got this looked at by the registrar in the Hosp and was told it would probably heal on its own and not to come back unless more complications. I was put on antibiotics. Two days later the hole is bigger and there is both fecal matter and thread from surgery coming out of this hole. I am now presuming I have an anal fistula. Has anybody experienced this after an anal sphincter repair?
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I am seven weeks post surgery for an Achilles' tendon rupture and still have intense pain from the blood pooling when I stand for even a minute to brush my teeth. After one minute I immediately have to lie down and elevate my leg otherwise it feels like it will explode. Has anyone else felt this 7 weeks post surgery?
I also can only bear minimum weight on the leg at this stage. At seven weeks does that sound normal? I had my tear at the connection to the heel and had haglund's deformity where part of my heel broke off. Anyone else have that and is minimal weight bearing at seven weeks normal for this type of tear.
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Has anyone found anything to help neuropathy after ALIF surgery? It has been 19 months and the pain is increasing. I cannot bear to wear anything except the loosest of clothing, I cannot walk without a cane or walker, I have new bowel and bladder function problems within the last 3 months. Is there anything that would even work temporarily to allow an airport ride? I buy even groceries online. I am in pain management with a respected doctor. I have have PT, water PT, massage, acupuncture, and narcotic medication. The fusion on L4/L5 and L5/S1 is fine; my life is not worth living.
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I had surgery for Hyperparathyroidism a year ago. I had 4 gland hyperplasia, which meant they removed 3 plus a part of the 4th gland. Immediately after surgery, I of course developed hypocalcemia. Since then, my Calcium numbers have fluctuated and I have had better and worse readings. However, my PTH has never gone above 19, and my last reading was 14. My Vitamin D is at 43 and my "active" D is apparently doing what it should be doing so I do not require Calcitriol to get things working. But, I still have issues with keeping my calcium up, and of course the attendant tingling, and etc.
My real concern is two-fold. One, is it safe to keep taking supplements given the conflicting data on males taking calcium, and Two, is there any harm in long term chronic hypocalcemia? I have read about heart issues and hypocalcemia, but I am assuming this is with respects very low and long term calcium issues. Also, anyone know of any ways to raise PTH at all? Funny how high PTH was an issue before surgery and now low PTH is...
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I was wondering how many of you are considering gastric band surgery?
I went o see my doctor about it, and he said that, although I fulfill all criteria for the op, they wouldn't consider me uless I have tried Orlistat first, so that's why he has given me them.
I have 8 stones to lose, so presumably wouldn't be able to take Orlistat for that long!
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My name is Gary. I am 57 and have had problems with hemorrhoids for years. It was getting to where I was spending two weeks out of the month basically ok due to constipation from opiate medication I have to take. Then one week where I use the prep H to push the roids back into place. Then often a week of just pain, stool softeners vs pain killers, and out of service.
I got referred to a surgeon recently and he said I had a bad case and set me up for surgery. They decided to do a colonistmy (colon probe. where I guess they pump you full of air and put a tube all the way up). I did not know that it was that extensive or I might of gone without it..at least not with this surgery.
I was told afterwards that I had some of the largest they had seen. Also the colon test showed some polyps they had to burn out. They did not look cancerous.
I had trouble getting cleaned out prior to surgery due to the pain and the opiates. As required I took 250 grams of miralax stool softener, 4 laxatives, and waited. I took them at 4 pm, had surgery lined up for 8:00 am with a 6:00am arrival. The drugs did not take effect until 1:00am so I was up until we had to leave for the hospital still on the toilet..and in severe pain.
I was still eliminating when we arrived. I was given a couple of ememas to use on myself. I couldn't hold them but they came out clear so they started the surgery, colon probe, and prostate exam.
I awoke after 2 hours of surgery. I was still under the anesthesia (I was put out) and not in terrible pain. I got up and was able to urinate. I had packing in me and was told to go home, take a bath, and they would come out. I had terrible cramps and gut pain, prostate pain, and severe anus pain. I have lots of stitches down there.
I went home and ate a small bowl of cereal and some oatmeal...and waited. I drank a bunch of juice and water but could not urinate. I was leaking blood everywhere. I took several baths and finally the packing came out. I took stool softeners and drank a lot. Finally the first meal, or what was left over from before, came out in the bath. I didn't have a full bowel push because of the pain but a bunch of crap, in small strings, some packing, and a huge amount of blood came out. I would say a pint.
I ate some more: a bacon and cheese bagel, some oatmeal, and stool softeners. I drank a bunch. I also had to take a bunch of painkillers. One the third day I had an involuntary bowel push but came up empty. I couldn't take the pain. Blood was still coming out in drips all the time with a small amount of feces. I called the doctor and got more pain killers. I set up a plan last night to have a bowel movement this morning. I ate some more oatmeal after one day without food. I took several sleeping pills and some painkillers to stop the urge to have a bowel movement. I had to get up at 12:00am and take more pain killers to stop an early bowel urge which would come up with nothing as is my experience. I awoke at 7:00am, as planned, and held the pain killers aside. I forced a bowel movement and produced a large pile of soft serve sh*t which was full of blood. There was more to come but, now 6 days out, I was in too much pain to push again.
It becomes a real fight to live. I am addicted to painkillers from years of degenerative disk disease and arthritis due to an 80 foot fall in 89. I don't get my refill until the 13th which is 3 more days. I have enough for today. I have stayed away from the long acting painkillers unless I run out. I hope to pass more later today. I will probably try the same procedure.
Again, it is the sixth day, and I still cannot walk without using the furniture. I try and move around as much as possible. I have some blood a fecal leakage which I clean up each time with a bath or a soaking wet warm wash cloth. Then I fold a washcloth in half and put in between my swollen cheeks until dry. They shave you down there and the stubble that grows back is very painful to the opposite side. I have never felt such pain. Each day has been a little better except for the third in which I was worse.
I would've still done the surgery if this all turns out ok. I will eat better, drink more, and do whatever I have to do to keep this from recurring.
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