MechanismLeakage of perilymph from the labyrinth may occur when the round or oval window is disrupted due to severe middle-ear barotrauma or forceful Valsalva maneuver.
ManifestationsThe symptoms of perilymph fistula
A perilymph fistula is a tear in the round and/or oval window membranes through which inner ear fluid is leaking.Learn More may include dizziness, vertigo, imbalance, nausea and vomiting. Some people experience ringing (tinnitus) and fullness in the ears, and many notice some hearing loss
The partial or complete loss of hearing from normal baseline.Learn More. Symptoms worsen with changes in altitude (elevators, airplanes or travel over mountains), weather changes and with physical exertion.
ManagementThis condition can usually be managed conservatively with absolute bed rest in the sitting position. Straining, sneezing, nose blowing, sexual activity, loud noises and middle-ear equalizing should be avoided to prevent pressure waves in the inner ear.
The round-window fistula often heals spontaneously within a week or two with this regimen, but if hearing loss progresses or the other features persist, it may be necessary to resort to surgery to repair the round-window leak.
Fitness to DiveEven after the acute symptoms of an oval- or round-window fistula have resolved, the diver's future in diving is questionable. Flying should be completely avoided for several months to allow complete healing of the injury or the surgical repair.
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