Vol.95 No.12 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 12 December 2002
The Tullio Phenomenon in a Patient with
Traumatic Perilymph Fistula
Hiroaki Sato and Kazuo Murai
(Iwate Medical University)
Koichi Sugihara
(Kinki University Nara Hospital)
A 19-year-old male who exhibited the Tullio phenomenon after barotrauma in the right ear is presented. The patient had developed right otalgia, vertigo, and nausea during exposure to loud sound after the right ear was beaten by a musical instrument five months earlier. Otoscopic examination demonstrated perforation scar in his right eardrum, however there was no cause of hearing impairment that could be identified. Fistula symptom was positive, but nystagmus could not be identified under Frenzel's glasses because the patient had congenital nystagmus. Exposure to tone burst sound stimulation with 1000 Hz at 90 dB to the right ear caused ocular deviation to the right and upward following nystagmus toward the left and upward. Surgical exploration of the right ear demonstrated perilymph leakage from the round window, but neither hypermobility nor subluxation of the stapes was found. The fistula was closed using a piece of temporal fascia and fibrin glue. Subjective symptoms of Tullio phenomenon disappeared postoperatively, but a slight downward nystagmus persisted during tone burst sound stimulation.
Key words : Tullio phenomenon, electronystagmography, traumatic perilymph fistula