To the Editor.—Perilymphatic fistulas remain one of the most controversial clinical issues in diagnostic otology today.1 The current state of the art regarding diagnosis is at best problematic. There exists no objective diagnostic testing for distinguishing the presence or absence of perilymphatic fistulas in a living human being. All clinical studies to date base their observations on subjective impressions made at the time of exploratory surgery.
The science surrounding the diagnosis of perilymphatic fistulas can only move forward if other investigators are willing to accept this general lack of objectivity and shed new light on this diagnostic problem. A future state-of-the-art presentation will hopefully include objective diagnostic testing that will benefit the patient with hearing loss and/or vertigo.
MORRIS MS. Perilymphatic Fistulas: State of the Art. Arch Otolaryngol Head Neck Surg. 1993;119(4):473. doi:10.1001/archotol.1993.01880160121020
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