title: Occult otologic fistulas as a cause of recurrent meningitis.
abstract: OBJECTIVE
  Occult perilymph fistulas may be the cause of unexplained non-epidemic meningitis.
  
  
  METHODS
  To review the case reports of 5 patients (3 females and 2 males aged 4-56) presenting with unexplained meningitis. All had sensorineural hearing loss of variable duration.
  
  
  RESULTS
  All patients were submitted to CT, MRI and MRI cisternography. All underwent exploratory tympanotomy to seal the fistula. In all patients the fistula could be located and sealed. All had no further attacks of meningitis and those who had serviceable hearing did not show any further deterioration.
  
  
  CONCLUSIONS
  In any case of recurrent meningitis an occult perilymph leak should be sought. A high degree of suspicion should exist if there are auditory or vestibular symptoms. Detecting and sealing of the defect will protect the patient against further attacks and deterioration of hearing.
authors.affiliation: Ain-Shams University, Faculty of Medicine, Cairo, Egypt. bemostafa@entainshams.com
authors.forename: B E
authors.initials: BE
authors.lastname: Mostafa
authors.forename: L
authors.initials: L
authors.lastname: El Fiky
authors.forename: A
authors.initials: A
authors.lastname: Khafagy
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000150:complications* / Q000175:diagnosis; D004432:Ear, Middle / Q000473:pathology*; D005260:Female; D005402:Fistula / Q000150:complications* / Q000175:diagnosis; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008581:Meningitis / Q000209:etiology*; D008875:Middle Aged; D010498:Perilymph; D012008:Recurrence