Quantitative diagnostic test for perilymph fistulas

F. O. Black, D. J. Lilly, L. M. Nashner, R. J. Peterka, S. C. Pesznecker

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Clinically, the definitive diagnosis of perilymph fistulas can only be made by tympanotomy. Results of various fistula tests based upon the vestibulo-ocular reflex have not correlated well with findings during tympanotomy. A new fistula test has been developed based upon vestibulo-spinal responses. By systematic removal of both visual and support-surface orientation references from the subject - leaving only vestibular control of postural reflexes - patients with perilymph fistulas demonstrated an increased (sometimes phase-locked) postural sway in response to sinusoidal changes in external auditory canal pressures. Results from 100 consecutively operated ears (64 patients) - 77 of whom underwent preoperative and postoperative moving-platform fistula tests - indicate that the test sensitivity is 97 percent for this highly selective patient population. Absolute specificity could not be determined because, on patients without clinical indications for surgery, tympanotomy is contraindicated.

Original languageEnglish (US)
Pages (from-to)125-134
Number of pages10
JournalOtolaryngology - Head and Neck Surgery
Issue number2
StatePublished - Jan 1 1987
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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