Sudden sensorineural hearing Loss: The question of perilymph fistula

Perilymph fistula (PLF) is an abnormal communication between the fluid-cont aining spaces of the inner ear and the air-containing spaces of the tempora l bone. It can be caused by trauma (penetrating, blunt, acoustic, or barome tric), infection, or inflammation, or if can be iatrogenic or congenital. I n addition, spontaneous PLF has been proposed but remains a focus of contro versy in the otologic community. PLF can cause hearing loss, tinnitus, aura l fullness, vertigo, and postural instability, symptoms that overlap substa ntially with other well-characterized otologic disorders. The difficulty in diagnosis, the subjective nature of intraoperative verification of perilym ph leakage, and the irregularity in reporting treatment outcomes have gener ated substantial confusion regarding the true incidence, management, and ac ceptance of PLF as a pathologic entity capable of producing acute ear sympt oms.