Comparison of postoperative results in suspected and confirmed cases of perilymphatic fistula.

Perilymphatic fistula is suspected on clinical symptoms, but must be confirmed by surgery. Exploratory tympanotomy was realized in 38 patients, presenting one or several symptoms of perilymphatic fistula. A leak was observed in 23 patients (61%). When a leak was not observed, the oval and round windows were filled with connective tissue. Preoperative and post-operative symptoms were compared in patients with or without leak: there was not significant difference between the two groups of patients. 63% of patients presenting fluctuant or sensorineural hearing loss improved or stabilized hearing after surgery. One patient, presenting a post-traumatic total deafness due to round window rupture, was immediately operated on, and recovered normal hearing. 84% of patients with vertigo or dizziness improved after surgery. The authors conclude that exploratory tympanotomy should be widely proposed when a perilymphatic fistula is suspected. Oval and round window should be grafted with connective tissue even if a leak is not observed.