Validity of spontaneous perilymphatic fistula

In response to recent articles questioning the validity of some perilymphatic fistula diagnoses, another small series is presented, reconfirming the enigmatic clinical appearance of perilymphatic fistula. Histologic evidence and experimental pathophysiology that explain the varied symptoms are reviewed. A pressed-fat fibrin-glue technique that seems to prevent recurrences is described, as well as a technique that may be helpful in confirming the presence of inapparent fistulas in surgery. Argument is advanced that this is a safe, minor surgical procedure helpful in alleviating vestibular and/or auditory symptoms in more than 70% of patients.