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Perilymphatic Fistula: Pathophysiology, Diagnosis and Management

Objective: To define the pathophysiology of perilymphatic fistula (PLF) and suggest guidelines for diagnosis and treatment. Material and Method: Review of the pertinent literature on clinical and basic reactions of the labyrinth to fenestration of the perilymphatic space. Presentation of personal experience with 20 patients explored for PFL. Results: Clinical and laboratory animal experiences indicate that a PLF induces a serous labyrinthitis with both auditory and vestibular symptoms and findings which are variable from patient to patient. Mechanical, barometric or concussive trauma is important in the diagnosis of sudden PLF. Since spontaneous healing of the PLF may occur, a 7- to 10-day period of conservative management is recommended before surgical intervention. Conclusions: PLF is an uncommon cause of hearing loss and vertigo. Strict adherence to criteria of history, functional results and management is recommended.