What Is a Perilymph Fistula, and How Is It Treated

What Is A Perilymph Fistula?

Perilymph fistulas are small blood clots located within the walls of your lungs. They form when tiny pieces of debris (called particulates) from cigarette smoke or other sources enter your airways through your nose and travel up into the lung wall. These particles block off a passage for oxygen and other vital nutrients needed by healthy cells in the body. Without these essential nutrients, the tissues die and eventually collapse causing death. If left untreated, perilymph fistulas can cause damage to the heart, brain, kidneys and other organs.

How Is a Perilymph Fistula Treated?

The most common treatment for perilymph fistulas is surgery to remove them. Surgery removes the blocked passage so it no longer blocks your breathing. Other treatments include medications such as steroids to reduce inflammation in the lungs and antibiotics to prevent infection.

Why Does a Perilymph Fistula Heal On Its Own?

If left untreated, perilymph fistulas will continue to grow larger and larger until they rupture, leading to death. However, if treated early enough after the onset of symptoms, perilymph fistulas can often be removed with minimal scarring. The healing process may take months or even years depending on how large the hole was before it ruptured.

Does a Perilymph Fistula Heals On Its Own?

The perilymph fistula healing process is a long one and sometimes it isn’t always possible to heal completely. The healing process can also vary from person to person. If the hole in your lung is too large, it may not be able to be patched up at all.

How Do You Know If a Perilymph Fistula Heals On Its Own?

Perilymph fistula healing can be detected through a simple medical test called an arteriogram. An arteriogram is a test that uses an x-ray or CT scan to examine the blood flow of your lungs. If the perilymph fistula has healed, it will no longer show up on the test.

What Is a Perilymph Fistula Tinnitus?

Tinnitus is another condition that is closely related to perilymph fistulas. Tinnitus occurs when nerve endings in your brain are stimulated due to damage to the ear or other structural problems such as a perilymph fistula. Tinnitus causes ringing, hissing, roaring, buzzing, whistling or other noises in the ears.

What Is the Perilymph Fistula Test?

A perilymph fistula test also sometimes called a fistula test is a medical test that measures how well blood passes through your lungs. A doctor inserts a small needle into the lungs to make a hole in one of the lobes, then air is pumped into that part of the lung to see if the hole stays open or collapses. The doctor then uses this information to determine if you have a perilymph fistula.

Do You Need a Perilymph Fistula Test?

If you are coughing blood or experience shortness of breath that is not relieved by medication, you should see your doctor immediately. These are both signs of a perilymph fistula and can be life-threatening if left untreated. Your doctor will order a fistula test to confirm the presence of a perilymph fistula.

What Is a Perilymph Fistula?

A perilymph fistula is an abnormal passageway between your lungs and the middle ear or nose. The blockage in this passageway causes chronic infection in the middle ear and problems breathing.

What Are the Symptoms of a Perilymph Fistula?

The most common symptoms of a perilymph fistula are nosebleeds and ear infections. A perilymph fistula can also cause hearing loss, ringing in the ears and a constant feeling of congestion.

How Does a Perilymph Fistula Develop?

A perilymph fistula develops as a result of damage to the middle ear or paranasal sinuses during head trauma. The middle ear is the part of the ear that lies between the eardrum and the brain and is connected to the back of the nose and throat. The sinuses are a series of air-filled cavities that lie between the bones of the face.

Do You Need Surgery for a Perilymph Fistula?

A perilymph fistula needs to be surgically repaired as soon as possible to prevent permanent ear damage and respiratory problems. If you experience any of the symptoms of a perilymph fistula, call your doctor immediately.

What Is an ATD?

An ATD, or arterio-venous fistula, is a passageway between an artery and a vein that occurs as a result of surgery. These types of fistulas are often used to provide a continuous access for the withdrawal of blood in patients who need regular blood transfusions or other types of regular medical treatment that requires repeated blood withdrawals.

What Are the Symptoms of an ATD?

Arterio-venous fistulas produce few, if any, symptoms in otherwise healthy individuals. If you do experience symptoms, it is because of either internal bleeding or the location of the fistula itself. If you are undergoing treatment for certain medical conditions, such as kidney failure, a large ATD may interfere with wound healing or cause irritation.

If You Have an ATD, Should You See a Doctor?

If you have an ATD, you should seek medical attention immediately if you experience any of the following symptoms:

Excessive bleeding, even from minor cuts or abrasions

A red, swollen or painful area around the fistula site

Fever or chills

Decreased urine output

Nausea or vomiting

These can all be signs of infection or other serious medical problems. If you experience any of these symptoms, call your doctor immediately.

What Do Doctors Look For When Diagnosing an ATD?

If you think you have an ATD, you should seek immediate medical attention. Your doctor will examine the fistula site and perform a physical test to see if blood is flowing in the vein where the needle is inserted. If blood is not flowing through the vein, the fistula needs to be repaired or removed.

What Causes an ATD?

Arterio-venous fistulas are a result of major trauma, such as an accident or serious injury, that damages the circulatory system. Arteries carry blood away from the heart and veins bring blood back to the heart.An arterio-venous fistula is an abnormal connection between an artery and a vein. In an arterio-venous fistula, blood bypasses the capillaries, which are responsible for filtering out unnecessary nutrients and sending them to organs and tissues that need them.

ATDs can also form as a result of vascular abnormalities present at birth (congenital). These congenital vascular abnormalities can cause an ATD to form along the path of abnormal blood vessels.

What Is the Treatment for an ATD?

The size and location of the fistula determine the type of treatment that will be necessary. Small fistulas located in areas that can be easily bandaged may not require surgical repair at all. Larger fistulas or those located in difficult-to-bandage areas may require surgery to repair or remove them.

What Is a Glomus Tumor?

A glomus tumor, or glomus vagale, occurs when a non-cancerous growth called a glomus body develops an arteriole that supply it with blood. Glomus bodies are responsible for sensing pain, temperature and other sensations associated with the body through the nervous system.

Who Is at Risk of Developing a Glomus Tumor?

Glomus tumors most commonly occur in middle-aged people, and they are rare. According to the American Cancer Society, people who smoke and do so for more than 20 years are at an increased risk of developing glomus tumors. These types of tumors can also occur among people who work with certain pesticides.

What Are the Symptoms of a Glomus Tumor?

Glomus tumors grow slowly and are rarely cancerous, but they can still cause severe pain. Some people may not experience any symptoms at all. If and when a glomus tumor develops, some of the following symptoms may occur:

Pain in the chest, arms or back

Pain in the face or jaw

Headaches or vision loss

Swelling in the hands, feet or limbs

Difficulty swallowing or breathing

Difficulty talking or slurred speech


How Is a Glomus Tumor Diagnosed?

The only definitive way to detect and diagnose a glomus tumor is through surgery; however, some tests can help your doctor to assess whether or not you have a glomus tumor. If you experience any of the symptoms listed above, you should seek medical attention immediately. Your doctor will examine you and ask about your medical history in an attempt to detect a glomus tumor.

How Is a Glomus Tumor Treated?

If your doctor finds evidence that you have a glomus tumor, he or she may refer you to an ear, nose and throat (ENT) doctor for further assessment. An ENT doctor can run a host of tests designed to help identify any potential glomus tumors, such as an MRI or a CT scan. If your doctor finds a tumor, he or she will remove it and send it to a lab for analysis. If the tumor is malignant, you may need further treatment, including chemotherapy and radiation.

How Does a Glomus Tumor Develop?

Glomus bodies are non-cancerous growths that are located in the heart. They contain small blood vessels, which allow them to react to external stimuli such as pain. When they develop an arteriole that supplies them with blood, they are called glomus tumors. If the glomus tumor is malignant it can spread to other parts of the body through the bloodstream and lymph nodes.

Sources & references used in this article:

Perilymph fistula: the Iowa experience by S Seltzer, BF Mccabe – The Laryngoscope, 1986 – Wiley Online Library

“Floating” Labyrinth: Pathophysiology and Treatment of Perilymph Fistula by Y Nomura, T Okuno, M Hara, YH Young – Acta oto-laryngologica, 1992 – Taylor & Francis

The perilymph fistula syndrome defined in mild head trauma by RJ Grimm, WG Hemenway, PR Lebray… – Acta Oto …, 1989 – Taylor & Francis