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Perilymph Fistula

Perilymph Fistula



What is It?

Perilymph Fistula is a tear or defect in one or both of the microscopic, thin membranes that separates the fluid-filled inner ear from the air-filled middle ear, allowing Perilymph (fluid) to seep into the middle ear.

Head trauma, which usually includes a direct blow to the head, is the most common cause of fistulas. They can, however, form as a result of sudden or dramatic changes in middle ear pressure, like when your ears "pop" in an elevator or a shift in pressure in an airplane cabin you are on, heavy lifting or very intense nasal blowing.
SCUBA diving in particular, are at danger of developing this illness. Water rushes into their ears when they dive, exerting pressure on the membrane. To counterbalance the water pressure, the diver must pop their ear to produce pressure in the middle ear (behind the ear drum). If the diver is unable to pop their ear, the increased pressure behind the ear drum is transferred to the inner ear membrane (round or oval window), resulting in an irregular connection between the inner and middle ear.

Infrequently, fistula can be present from birth or develop as a result of persistent or severe ear infections.

Air pressure changes normally have no effect on your inner ear. Changes in middle ear pressure, on the other hand, will have a direct impact on the inner ear, activating the balance and/or hearing structures and causing PLF symptoms.


  • Ear Fullness
  • Dizziness (Spinning)
  • Imbalance
  • Nausea
  • Vomiting

When to See Doctor?

Some perilymph fistulas heal on their own with rest. However, if your symptoms do not improve in 2-3 days you should consult a physician. Worsening pain after three days, persistent spinning sensation, or vomiting should make you go to the doctor.