Idiopathic perilymphatic fistula has been confirmed with clinical-temp
oral bone histopathologic studies as a separate inner ear disease. Cri
teria for its diagnosis are sudden or progressive sensory hearing loss
, or for vestibular components, a positive fistula test, constant dise
quilibrium, and positional nystagmus or postural vertigo. Nonsurgical
treatment, such as keeping the head higher than the heart and avoiding
heavy lifting, can be tried. When it is ineffective or when there is
sudden hearing loss without improvement, surgical sealing of the leak
should be attempted.