PRESSURE-INDUCED OCULAR TORSION

We describe 3 patients within whom ocular torsion could be induced by application of positive air pressure to one external ear canal. In all cases, the superior pole of the eye rotated away from the stimulated ear when positive pressure was applied, The amplitude of torsion range d from 3 degrees to 16 degrees. Exploratory tympanotomy was performed in all 3 patients. In 2 patients, round-window fistulas were found and repaired. In the third patient, no fistula was noted but the oval- an d round-window areas were patched, There was no resolution of symptoms after surgery in any patient. Based on these cases, patients presenti ng with pressure-induced ocular torsion are unlikely to have resolutio n of their symptoms, even when a perilymphatic fistula is confirmed an d repaired, We hypothesize that pressure-induced ocular torsion is cau sed by an irreversible juxtaposition of the utricle and stages footpla te.