title: The perilymphatic fistula.
abstract: This study attempts to establish clinical criteria that would enable physicians to decide which patients with sudden cochlear and vestibular symptoms should be explored surgically in search of a perilymphatic fistula, in the absence of history indicating trauma to the inner ears. For this purpose, we studied forty-five patients whom we operated on because of suspected perilymphatic fistulas. The patients were into two groups: Group A (twenty patients) had previously undergone stapedectomy. Group B (twenty-five patients) had not undergone surgery in the past. Most of our patients experienced a rather acute onset of vertigo, unsteadiness, hearing loss, and tinnitus. We found no significant difference in the symptoms or signs between the patients who had a fistula and those in whom a fistula was not found, nor between those who underwent stapedectomy previously and those who did not. Most of the patients in Group B (75 percent) with fistula did, however, have a history of some stress or trauma preceding the sudden onset of symptoms. Yet some did not. We had three patients with no such history, nor had they undergone a previous stapedectomy. Basically, we are left with a dilemma: whether or not to explore a particular ear with appropriate symptoms and signs but without a traumatic history--knowing that about a quarter of these patients may have a perilymphatic fistula.
mesh_terms: D000328:Adult; D007758:Ear, Inner / Q000293:injuries*; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications / Q000209:etiology* / Q000601:surgery; D008297:Male; D013201:Stapes Surgery / Q000009:adverse effects*