What is a Perilymph Fistula?

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  • Written By: Mary McMahon
  • Edited By: C. Wilborn
  • Last Modified Date: 18 October 2019
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A perilymph fistula is an opening between the inner and outer ear that allows perilymph, the fluid filling the inner ear, to leak out. There are a number of reasons why people can develop perilymph fistulas, and there are several available treatment options. Treatment is usually supervised by an ear, nose, and throat (ENT) specialist, a doctor who specializes in ear care and can provide the highest standard of care to patients with ear-related medical problems.

One of the most common causes for a perilymph fistula is a head injury that damages the delicate membranes between the inner and outer ears. Patients can also develop fistulas as a result of infections or trauma to the ear. In some patients, the hole is congenital and the patient has a fistula from birth. Knowing the cause can be an important aspect of developing a treatment plan.

Leakage of perilymph disrupts the vestibular system that mediates sense of balance. People with perilymph fistulas can develop vertigo and dizziness, feel nauseous, and have difficulty balancing. Some experience symptoms like vomiting. These symptoms are sometimes obscured by symptoms related to trauma and head injury, as seen when people have concussions, which can also cause dizziness, nausea, and vomiting. Careful examination by a neurologist and an ENT are advised for patients with head injuries for the purpose of identifying any and all associated injuries.


Also known as a labyrinthine fistula, a perilymph fistula is often treated conservatively, by waiting to see what happens. The doctor will identify the cause and treat it, if necessary, and will periodically check up on the patient to see if the hole is healing up on its own. If spontaneous healing does not occur, surgical options will need to be considered. Surgical repair of a perilymph fistula can include inserting drainage tubes into the ear or repairing the membranes in the ear, depending on the nature of the fistula.

People who experience head injuries and notice symptoms like ringing in the ears, nausea, difficulty balancing, and hearing problems should seek medical attention. These symptoms can be signs of a perilymph fistula, along with other serious conditions. Receiving treatment promptly reduces the risk of developing serious complications such as permanent hearing impairments. It is helpful to provide as much information as possible about any symptoms experienced and any recent injuries, no matter how minor they may seem, as this information may be relevant to diagnosis and treatment.


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