During VNG, pressure applied to the external auditory canal via pneumatic otoscopy induces vertical-torsional nystagmus. This positive fistula test is most characteristic of which condition?
- A Meniere's disease
- B Perilymph fistula ✓
- C Vestibular schwannoma
- D BPPV
Correct answer: B. Perilymph fistula
Explanation
A positive pressure-induced fistula test indicates an abnormal communication between the middle and inner ear, allowing pressure changes to directly stimulate the vestibular end organs. This is characteristic of perilymph fistula and also seen in superior canal dehiscence. Meniere's disease and vestibular schwannoma do not produce pressure-induced nystagmus on routine fistula testing.
Reference: Cummings Otolaryngology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.