Abstract: . . .  they worsen, exploratory tympanotomy is indicated. If a fistula is present, it can be surgically sealed. DISCUSSION: While fistulae may occur spontaneously, most are associated with head injury or barotrauma, especially in the active duty population. They may also occur as a result of Q-tip misadventure or improper cerumen irrigation technique. As surgery does not always seal the fistula, and recurrence is possible, various waiting periods are prescribed for different classes of personnel. The longest period is for DNA's, as there is a considerable safety issue should acute vertigo occur during flight. ICD-9 CODE: 386.4 Oval / Round Window Fistula U.S. Navy Aeromedical Reference and Waiver Guide ENT - 15  . . .
. . .  barometric pressure changes, especially ones that might require a Valsalva maneuver. If hearing and vestibular symptoms don't improve, and certainly if they worsen, exploratory tympanotomy is indicated. If a fistula is present, it can be surgically sealed. DISCUSSION: While fistulae may occur spontaneously, most are associated with head injury or barotrauma, especially in the active duty population. They may also occur as a result of Q-tip misadventure or improper cerumen irrigation technique. As surgery does not always seal the fistula, and recurrence is possible, various waiting periods are prescribed for different classes of personnel. The longest period is for DNA's, as there is a considerable safety issue should acute vertigo occur during flight. ICD-9 CODE: 386.4 Oval / Round Window Fistula U.S. Navy Aeromedical Reference and Waiver Guide ENT - 15  . . .
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