Perilymphatic Fistula
Perilymphatic fistula (PLF) is a type of cerebrospinal fluid leak that can cause dizziness, hearing loss, and tinnitus. It occurs when the membranes surrounding the inner ear break down, allowing fluid to flow between the middle ear space and the brain. PLF is typically caused by head trauma, but it can also be caused by chronic inflammation or infection of the ear or meningitis. The most common symptom of PLF is vertigo or a sensation of dizziness and spinning, but it may also cause hearing loss or tinnitus (ringing in the ears).
PLF can cause vertigo in two ways. First, there is direct damage to the inner ear’s vestibular system. This part of the inner ear includes tiny hairs that monitor balance and orientation about gravity. When PLF occurs, these hairs can become damaged and send incorrect signals to the brain about where our bodies are positioned. Second, PLF causes pressure on the eighth cranial nerve. This nerve sends balance information from the inner ear to other parts of the brain, like the cerebellum (which helps us coordinate movement) and reticular formation (which controls arousal levels and consciousness). By applying pressure on this nerve, PLF can cause symptoms like dizziness, confusion, ringing in the ears, and headaches.
