Perilymphatic gusher: Unpredictable complication of stapes surgery
DOI:
https://doi.org/10.34631/sporl.93Keywords:
Otosclerosis, Perilymphatic Gusher, Stapedotomy, Congenital X-linked deafnessAbstract
The perilymphatic gusher (PG) is a known complication ofstapedial surgery. The flow of perilymph in fact corresponds to
cerebrospinal fluid (CSF) that has access to the vestibule and
from here to the middle ear, making it difficult to complete the
surgery and to obtain a good functional result. Some cases are
associated with congenital X-linked deafness type 3 (DFN3). We
present three cases of PG in patients undergoing stapedotomy,
one in a patient with a unilateral hearing loss, the second in a
patient who previously had a contralateral stapedotomy with
success, and the last in a revision surgery in which there had
been no leakage of perilymph during the first surgery. The
PG appeared as an unpredictable complication of stapedial
surgery. The control of perilymphatic flow includes in addition
to sealing the oval window if possible with the prosthesis,
the use of methods to decrease the CSF pressure. In a male
patient with mixed hearing loss, family history of hearing loss
and stapedial reflexes present, X-linked deafness should be
suspected, and CT allows to evaluate IAC enlargement or other
vestibular malformations. In the absence of family history, it is
difficult to determine preoperatively which patients are at risk.
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