To the 28 cases of rupture of the inner ear windows reported during the past five years, 19 cases are now added. Many have resulted from accidental trauma or barotrauma, with initial manifestation of gait disturbance, ataxia, episodic vertigo, and sensorineural hearing loss of varying severity.
The finding of positional nystagmus, a positive Romberg or fistula sign with a sensory hearing loss makes the diagnosis of an inner ear window rupture most probable. Surgical exploration of the middle ear is necessary to identify and close the fistula.