title: [Diagnosis and treatment of post-traumatic perilymphatic fistula: Report of 16 cases].
abstract: BACKGROUND
  When facing cochleovestibular symptoms such as hearing loss, dizziness or unsteadiness, or a tinnitus evolving in the aftermath of a cranial trauma or overpressure in the form of inner ear barotrauma after diving or a from blast, a perilymphatic fistula must be considered.
  
  
  METHODS
  We present a homogenous prospective series of 16 cases of perilymphatic fistulae occurring after head trauma or overpressure between 2003 and 2011. Patients suspected of suffering from a perilymphatic fistula and presenting with the following criteria were included: the occurrence after a variable delay of cochleovestibular symptoms (vertigo, tinnitus, and hearing loss) in the aftermath of a head trauma or overpressure. All patients received medical treatment with intravenous corticosteroids. Failure of the initial treatment and in the presence of clinical data suggesting a perilymphatic fistula, an exploration of the middle ear was performed.
  
  
  RESULTS
  13 patients (81.2% underwent surgical exploration with early and stable subtotal recovery of hearing in 90%, a rapid disappearance of vertigo in 89.9%, a loss of tinnitus in 45% and in 27% improvement.
  
  
  CONCLUSIONS
  The diagnosis must be supported by various diagnostic tests. If evidence in favor of a perilymphatic fistula is credible, surgery has always achieved an excellent functional outcome.
authors.affiliation: Hôpital d'Instruction des Armées Sainte Anne, Service ORL et CCF, 83000 Toulon, France. jbmorvan@hotmail.com
authors.forename: J B
authors.initials: JB
authors.lastname: Morvan
authors.forename: O
authors.initials: O
authors.lastname: Cathelinaud
authors.forename: D
authors.initials: D
authors.lastname: Rivière
authors.forename: L
authors.initials: L
authors.lastname: Vatin
authors.forename: F
authors.initials: F
authors.lastname: Bousquet
authors.forename: P
authors.initials: P
authors.lastname: Verdalle
mesh_terms: D000328:Adult; D001469:Barotrauma / Q000150:complications; D005260:Female; D005402:Fistula / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016489:Head Injuries, Closed / Q000150:complications; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014012:Tinnitus / Q000209:etiology; D014717:Vertigo / Q000209:etiology