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Sept 21, 1984

Perilymphatic Fistula

Author Affiliations

Washington Hospital Center Washington, DC

JAMA. 1984;252(11):1407. doi:10.1001/jama.1984.03350110013005

To the Editor.—  It is becoming less frequent that a new diagnosis is added to the "standards" of today's medical information. However, experience over the last 15 years has established a common diagnosis in the field of otology that I venture to guess few readers would recognize: perilymphatic fistula (also known as labyrinthine membrane rupture). In essence, this is a rupture of either the oval or round window membranes, allowing the perilymph of the inner ear to leak into the middle ear.Almost a century ago, fistulas of the bony labyrinth with leakage of perilymph were known to occur most frequently from chronic infections or cholesteatomas. Perilymph fistulas secondary to stapes surgery were reported in 1967 by Harrison et al.1 A year later, Fee2 reported a perilymph leak from nonsurgical head trauma. The description of the pathophysiology of noninfectious and nonsurgical ruptures is generally credited to Goodhill.3