Basically acts like a 3rd window and dissipates the sound energy.
Clinically with vertigo (Tullios Phenom–vertigo with noise) (Hennebert’s Sign–vertigo with pneumatic otoscopy positive pressure)
Hearing loss, autophony of voice with no autophony of breathing (unlike patulous ETT)
See on a thin cut CT (actually overly sensitive)
Have hearing loss
+ VEMPS–Lower threshold on C-Vemps—more symptoms
May be what we thought previously to be a PLF which is why Round window reinforcement works.