What is a pressure fistula test in electronystagmography (ENG)?

Updated: Aug 06, 2019
  • Author: Angela G Shoup, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Some patients have vertigo caused by a perilymph fistula. Fistula testing can be conducted with ENG to determine which patients are likely to benefit from perilymph fistula repair surgery. [19]

For the pressure fistula test, the patient is placed in an upright position. While the patient is involved in mental tasks, recordings are conducted with the patient’s eyes open in the dark (wearing infrared goggles) or with eyes closed with electrodes. The presence or absence of spontaneous nystagmus is noted. Next, a probe from an immittance bridge is placed in the ear canal and a seal is obtained. Pressure is then varied from 0-200 mm H2 O and held for approximately 15 seconds. Pressure is then decreased to -400 mm H2 O and held for 15 seconds. The patient is questioned for subjective symptoms.

The presence of a fistula is confirmed if the pressure causes nystagmus.

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