New York Eye and Ear Infirmary
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Perilymphatic Fistula

Perilymphatic fistula is an abnormal leakage of fluid (perilymph) from the inner ear to the middle ear. This fluid usually leaks through one of two "windows" (thin membranes) that separate the inner ear from the middle ear and seal the fluid (perilymph) within the inner ear. The membranes are called the oval window (under the stapes bone) and the round window.

What causes perilymphatic fistula?
Perilymph fistula is almost always the result of sudden pressure changes within the middle ear or inner ear.

What are the symptoms of perilymphatic fistula?
The most common symptoms are hearing loss and/or dizziness. The history is the key to diagnosis. Patients will say, for example, that their symptoms began after a painful air descent, or after scuba diving, or after being struck over the ear. Perilymph fistula can mimic Meniere's Disease.

How is perilymphatic fistula diagnosed?
There is no hearing test, balance test or X-ray test that can make this diagnosis. The fluid leaking is microscopic in volume and not visible to the physician in the office, even using an examining microscope. The presence of a fistula can only be confirmed by surgical exploration of the middle ear.

How is it treated?
Treatment is surgical repair of the leak.

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