Perilymph Fistula (Ear)... ?
Herein is a brief -- non-medical -- synopsis of my ear issue:
Approximately 3 years ago I was diagnosed with a cholesteatoma, after experiencing months of dizziness and vertigo. Shortly thereafter the cholesteatoma was excised, as was part of the incus bone. Initially my symptoms subsided, however, my dizzy symptoms would reappear intermittently. About 1.5 years later the cholesteatoma remerged and, as such, I underwent another surgery to correct this aberration. Furthermore, the incus was fully removed during the second surgery. Since the second surgery I have been experiencing dizziness, but not vertigo. I have been able to determine symptomatic triggers and partially avoid the dizziness.
In regards to my symptoms, I’ve noted that during a 3-month period (~2 months ago) when I was undergoing rigorous exercise, I was becoming dizzy during and directly after my workouts. This dizziness would persist for roughly 1-2 hours, and the dizziness was exacerbated when I ate food 30 mins post workout (I contribute this to chewing), and was ameliorated when I rested. I have since reduced strenuous physical activities (I usually only do a light jog 3-4X/week) and have tried to rest as much as possible. This change in activity, which encompasses a two month period, has made me feel exceptionally better (i.e., fewer dizzy spells). Nevertheless, I do experience bouts of dizziness.
Outside of dizziness here are a couple more points that may be meaningful. I normally experience a stiff neck that is concomitant with the onset of dizzy spells; nausea (rare); I have become sensitive to bright lights on computer screens, theatre screens, or strolling through the grocery store; following flights on the airplane I can become dizzy; I have noted that fluctuations in weather are concomitant with my dizziness; extreme difficulty in concentrating when symptoms are present; and I have a positive Romberg test. I always favour (i.e., fall) towards the side of my injured ear. Since resting, I have had a negative Romberg test.
Last note, 2 years ago I had an MRI of my brain and nothing remarkable was present.
Taken together, I suspect I have a perilymph fistula. My ENT concurs with my speculation. He is very doubtful it's a SCD. Do you think it is worth surgically investigating for a fistula? Are there any major complications with this sort of exploratory work? Is it fair to speculate that the ossicular chain reconstruction (i.e., removal of the incus) has disrupted the stapes and imparted a fistula on the oval window?
We have gone ahead with an ENG test and booked an MRI for my ear. As mentioned, the ENG test revealed nothing remarkable, at least according to the ENG technician. I am not sure we’ll see anything via MRI. I will let you know what transpires.
This darn ear problem has been the bane of my existence, and I am very grateful for you taking time to assist me in this endeavour.