Hydrops following perilymph fistula repair

A series of 15 ears were explored for perilymph fistulas. Fifteen fistulas were found in 13 ears. Two cases are presented which developed hydrops-like symptoms only after closure of their fistulas. Closure of the other patients' fistulas was successful in relieving vertiginous symptoms, although hearing seldom improved. There were no significant complications of surgery. Fat failed as a graft material 4 of 10 times, whereas vein and perichondrium were not associated with recurrence of symptoms. The ENG-fistula test, as described by Daspit and associates, correctly predicted the presence or absence of a fistula in 7 of 8 ears tested. Hennebert's sign correctly predicted fistulae in 2 ears, and Hennebert's symptom was associated with proven fistulae in 9 of the 10 times it was present. Because of the low morbidity and the high success rate of surgery, a patient with a history suggestive of a perilymph fistula should have exploratory tympanotomy, particularly if the ENG-fistula test is positive.