外リンパ瘻罹患後遅発性に発症した良性発作性頭位眩暈症の一例

Abstract

A 12-year-old male experienced left-sided hearing impairment, tinnitus, and vertigo after being hit by a volleyball. Pure tone audiometry showed severe, mixed left hearing loss and nystagmus to the right side. We diagnosed perilymphatic fistula and treated it conservatively. After ten days, his vertigo had disappeared and hearing on his left side showed improvement except at 2,000 and 8,000 Hz. However, he experienced slight dizziness after discharge from our hospital. About eleven months later, because of severe vertigo, he again came to our hospital. We diagnosed benign paroxysmal positional vertigo (BPPV) based on his symptoms and the characteristic nystagmus. We performed the Epley maneuver, and his vertigo and nystagmus disappeared the next day. Exploratory tympanotomy was carried out, but no sign of a perilymphatic fistula was detected. He experienced BPPV again, and so we tried the Epley and Lempert maneuver. We believed his prolonged dizziness was due to a partial collapse of the utricular wall, a condition called floating labyrinth. This phenomenon may occur with migration of otoliths from the utricle, leading to BPPV.