Migraine, Headache, and Third Mobile Window Syndrome

An illustrative summary that highlights the spectrum of the most common complaints from patients with perilymph fistula (PLF) was published over a quarter century ago [1]. No doubt many of these patients had third mobile window syndrome (TMWS) due to bony sites of dehiscence not yet discovered. In this publication the authors reported the percentage of their patients reporting each of the 13 most common complaints. The three most frequent complaints were disequilibrium, headache and dizziness. Other important clinical symptoms included cognitive dysfunction, nausea, visual disturbance, and objective as well as subjective hearing loss. The most common symptoms of superior semicircular canal dehiscence (SSCD), and other sites of TMWS, include pseudoconductive hearing loss (bone conduction hyperacusis), autophony, pulsatile tinnitus, and sound- or pressure-induced vertigo [2–11]. Some of the internal sounds that patients report as being particularly disturbing include hearing their eyes move and/or blink, hearing their heels strike loudly, chewing (often so loud they need to stop chewing to hear what others say), belching or borborygmi. Patients also experience aural fullness typical of endolymphatic hydrops. This spectrum of symptoms observed is summarized in Chap. 1.