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Fistula test

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Indications:

  • any patient with a history of giddiness in whom erosion of the bony labyrinth is suspected e.g. by infection, cholesteatoma, tumour
  • any asymptomatic patient in whom cholesteatoma is discovered clinically

Method - alteration of pressure in the external auditory meatus by either:

  • repetitive pumping action on the tragus with the index finger
  • pneumatic otoscope

Positive test:

  • patient develops vertigo or nystagmus
  • indicates:
    • an abnormal communication between the membranous labyrinth and the external auditory meatus
    • functioning vestibular end organ

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