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A perilymph fistula occurs when there is a tear in the oval or round window that separates the middle ear from the inner ear. The inner ear is filled with perilymph fluid; when there is a tear, this fluid leaks into the middle ear space.

The most common cause of a perilymph fistula is head trauma and barotrauma.


  • Hearing loss (fluctuating or sudden)
  • Vertigo
  • Tinnitus
  • Ear pressure


A perilymph fistula may resolve on its own with strict bed rest. Medications can help with vertigo and other symptoms. However, surgery is often recommended.

A surgical procedure called Round Window Fistula Repair is often performed.

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