Perilymphatic Fistula: an approach to diagnosis and management that provides surer diagnosis and provides medical and surgical management options: report of six illustrative recent cases.

Perilymphatic Fistula (PLF) remains a controversial topic and its management is challenging. Various etiologic events have been proposed and spontaneous PLF has been described 1. Diagnostic methods and strategies have been reported in the literature but no standard algorithm exists. The most accepted diagnostic method remains intra-operative confirmation of perilymph leak at oval window or round window. However, concerns have been raised regarding excessive surgical intervention given the lack of pre-operative confirmatory tests. We have developed a diagnostic strategy that has been successful in our hands. The aim of this study is to present six patients with PLF who underwent surgical repair. We describe our approach in the evaluation and management of these patients. We discuss the diagnostic tests and the operative technique used in management of these patients and we provide a review of the literature in support of our approach.