A Website About 

Dizziness, Imbalance, Falls, Hearing Loss,

& Continuing Education Courses

 Academic Information on the Following Topics

Sponsored by:   Jordan Hearing and Balance, LLC  South Jordan Utah 

Lynn S. Alvord PhD



                              Perilymph Fistula


    This is a small leak of inner ear fluid that can occur when a person strains, exercises, coughs, sneezes or bears down causing a dizziness or vertigo feeling that usually only lasts minutes to an hour or so following the activity.  The leak is from the cochlea and related balance organs, usually at the site of the “oval” window or “round” window, which are areas on the medial wall of the middle ear space.  These leaks most commonly follow an ear surgery (more involved than tube placement), but can also occur spontaneously.  If the leak is severe enough, there will be a sensorineural hearing loss as well. 

 There are some clinical tests for perilymph fistula, such as when a tympanogram makes the patient dizzy, or when the clinician instills some pressure into the ear canal such as with the exam scope (otoscope), which causes momentary dizziness. 

The main gold standard test, however, is an exploratory surgery.  The condition can often be corrected by patching the leak surgically.  

Another disorder that can cause some of the same symptoms is superior canal dehiscence, which is a small leak or weakness in the wall of the superior semicircular canal.  In addition to the dizziness, the patient with SSCD hears internal body sounds at a louder volume than normal.  The clinical test for this disorder is vestibular evoked myogenic potential (VEMP), which audiologists perform.  See section on superior canal dehiscence.