{"id":16618,"date":"2026-10-06T11:34:00","date_gmt":"2026-10-06T08:34:00","guid":{"rendered":"https:\/\/ent.gr\/?p=16618"},"modified":"2026-10-06T11:35:48","modified_gmt":"2026-10-06T08:35:48","slug":"third-window-syndrome","status":"publish","type":"post","link":"https:\/\/ent.gr\/en\/third-window-syndrome\/","title":{"rendered":"Third Window Syndrome: Symptoms, Diagnosis &#038; Treatment"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#What_causes_third_window_syndrome\" >What causes third window syndrome?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Types_of_third_window_syndrome\" >Types of third window syndrome<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Aetiology\" >Aetiology<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Signs_and_symptoms_of_third_window_syndrome\" >Signs and symptoms of third window syndrome<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Diagnosis_of_third_window_syndrome\" >Diagnosis of third window syndrome<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Diagnostic_tests\" >Diagnostic tests<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#Management_and_treatment_of_third_window_syndrome\" >Management and treatment of third window syndrome<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/ent.gr\/en\/third-window-syndrome\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<\/p>\n<div style=\"font-family: helvetica; font-size: 18px;\">\n<strong>Third window syndrome<\/strong> describes a group of vestibular and auditory symptoms that result from a leakage of pressure and\/or fluid from the inner ear structures, due to an abnormal communication.<\/p>\n<div id=\"attachment_16615\" style=\"width: 490px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-16615\" class=\"wp-image-16615\" src=\"https:\/\/ent.gr\/wp-content\/uploads\/2026\/10\/sindromo-tritis-thyridas.jpg\" alt=\"Woman coughing with a hand on her chest, surrounded by blue swirls depicting the dizziness of third window syndrome\" width=\"480\" height=\"274\" srcset=\"https:\/\/ent.gr\/wp-content\/uploads\/2026\/10\/sindromo-tritis-thyridas.jpg 1000w, https:\/\/ent.gr\/wp-content\/uploads\/2026\/10\/sindromo-tritis-thyridas-300x171.jpg 300w, https:\/\/ent.gr\/wp-content\/uploads\/2026\/10\/sindromo-tritis-thyridas-768x439.jpg 768w, https:\/\/ent.gr\/wp-content\/uploads\/2026\/10\/sindromo-tritis-thyridas-700x400.jpg 700w\" sizes=\"auto, (max-width: 480px) 100vw, 480px\" \/><p id=\"caption-attachment-16615\" class=\"wp-caption-text\">Dizziness when coughing: a typical symptom of third window syndrome<\/p><\/div>\n<h2><span class=\"ez-toc-section\" id=\"What_causes_third_window_syndrome\"><\/span>What causes third window syndrome?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The symptoms are caused by the presence of an abnormal third mobile window in the bony labyrinth of the inner ear. Normally, the inner ear has only two mobile windows: the oval and the round window. This pathological opening disrupts the normal biomechanics of the inner ear.<\/p>\n<p>Third window syndrome is most commonly due to abnormalities that cause dehiscence (absence) or near-dehiscence (thinning) of bony sections lying superior to the canal.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Types_of_third_window_syndrome\"><\/span>Types of third window syndrome<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A disruption in pressure due to a weakness or opening in the tissues or bones of the inner ear can cause third window syndrome. These may occur:<\/p>\n<ul>\n<li>At blood supply or nerve attachment sites to the hearing or balance organs.<\/li>\n<li>In the bones connecting the middle ear to the inner ear.<\/li>\n<li>In the openings connecting the hearing and balance organ to their fluid supply.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Aetiology\"><\/span>Aetiology<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>The cause of the disruption may be:<\/p>\n<ul>\n<li>Genetic tendency.<\/li>\n<li>Differences in skull shape and organs.<\/li>\n<li>Head trauma and surgery.<\/li>\n<li>Barotrauma or straining.<\/li>\n<li>Tumors or infections.<\/li>\n<li>Elevated intracranial pressure.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Signs_and_symptoms_of_third_window_syndrome\"><\/span>Signs and symptoms of third window syndrome<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Symptoms may include:<\/p>\n<ul>\n<li>Sound-induced dizziness.<\/li>\n<li>Dizziness from physical strain, like weightlifting, coughing, sneezing or blowing the nose.<\/li>\n<li>Difficulty in maintaining a steady gaze when hearing loud sounds or when experiencing physical strain.<\/li>\n<li>Autophony (hearing your own voice louder than normal).<\/li>\n<li>Hearing other internal noises abnormally, such as heartbeat, eye movement or blinking.<\/li>\n<li>Mixed hearing loss.<\/li>\n<li><a href=\"https:\/\/ent.gr\/en\/diagnosis-and-management-of-hyperacusis\/\">Sensitivity to loud sounds<\/a>.<\/li>\n<li><a href=\"https:\/\/ent.gr\/en\/what-causes-tinnitus\/\">Tinnitus<\/a>.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Diagnosis_of_third_window_syndrome\"><\/span>Diagnosis of third window syndrome<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The diagnosis is determined by a specialized ENT-Neurootologist at EYiasis, through a complete medical history, physical examination and an audiogram.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Diagnostic_tests\"><\/span>Diagnostic tests<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Further tests may be carried out at the <a href=\"https:\/\/ent.gr\/en\/neuro-otology-exam-lab-vertigo\/\">EYiasis Vertigo and Neuro-otology Lab<\/a>:<\/p>\n<ul>\n<li><strong>Tullio testing:<\/strong> evaluation for nystagmus while putting sound in the ear.<\/li>\n<li><strong>Fistula testing:<\/strong> evaluation for nystagmus or imbalance with pressure applied to the ear drum.<\/li>\n<li><strong>Valsalva testing:<\/strong> evaluation for nystagmus when the patient strains.<\/li>\n<li><strong>High-resolution CT<\/strong> or <strong>vestibular-evoked myogenic potential (VEMP) testing<\/strong>, when required.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Management_and_treatment_of_third_window_syndrome\"><\/span>Management and treatment of third window syndrome<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>Conservative management:<\/strong> lifestyle changes, such as avoiding triggers including loud sounds and physical strain, may be implemented to tolerate symptoms and reduce more severe effects. Treating any coexisting or exacerbating conditions, such as migraine or <a href=\"https:\/\/ent.gr\/en\/vestibular-migraine\/\">vestibular migraine<\/a>, may also improve the symptoms.<\/li>\n<li><strong>Surgical repair:<\/strong> it may sometimes be recommended if the patient has more severe and intolerable symptoms.<\/li>\n<\/ul>\n<p>If loud sounds, coughing or physical effort make you dizzy, <a href=\"https:\/\/ent.gr\/en\/contacts\/\">contact EYiasis<\/a> for a full neuro-otological evaluation.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ol>\n<li>Iversen MM, Rabbitt RD. Biomechanics of Third Window Syndrome. Front Neurol. 2020;11:891.<\/li>\n<li>Lazarou I, Sideris G, Papadimitriou N, Delides A, Korres G. Third Window Syndrome: An Up-to-Date Systematic Review of Causes, Diagnosis, and Treatment. J Audiol Otol. 2025 Apr;29(2):86-94.<\/li>\n<li>Suzuki M, Ota Y, Takanami T, Yoshino R, Masuda H. Superior canal dehiscence syndrome: a review. Auris Nasus Larynx. 2024;51:113-9.<\/li>\n<li>Basura GJ, Cronin SJ, Heidenreich KD. Tullio phenomenon in superior semicircular canal dehiscence syndrome. Neurology. 2014;82:1010.<\/li>\n<\/ol>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Third window syndrome: causes, symptoms like sound-induced dizziness and autophony, diagnosis and treatment. 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