Perilymphatic fistula and its interest to audiologists.

Forty-one patients who had sudden hearing loss associated with spontaneous perilymphatic fistllas were reviewed in this investigation. A history of physical exertion or an upper respiratory infection prior to the onset of hearing loss strongly suggests the presence of spontaneous perilymphatic fistula. However, absence of such a history does not necessarily preclude the possibility of membrane rupture. A great variation in audiologic and vestibular findings was observed. Tinnitus was present for most patients and vertigo or disequilibrium was reported by some. Findings support the need for surgical exploration in patients with sudden hearing loss when a perilymphatic fistula is suspected. Postoperative success in restoring hearing function in cases with perilymphatic fistula is good if the fistula is closed within two weeks after the initial insult. Delay in closure of such fistulas can cause irreversible loss of hearing.