Abstract
One hundred twenty-seven records of patients who received exploratory tympanotomy for suspected perilymph fistula (PLF) were reviewed. Surgical selection was based on history of onset, including such factors as trauma, barometric pressure change, or CFS pressure change. Patients with spontaneous onset of hearing los were also studied if either a sudden loss or fluctuating loss with progressive deterioration occurred, or if severe hearing loss was not respond to conservative therapies within two weeks from onset. All operations, except one in a child (9 years old) were done under local anesthesia. In nearly all patients, both the oval and round windows were grafted, whether PLF was confirmed or not. PLFs were identified in 62 patients (confirmed group), and not identified in 65 patients (uncertain group). To determine how often we failed to find fistulas during explor atory tympanotomy in patients who actually had PLF, background data such as age, sex, history of onset, preoperative audiograms, duration from onset to operation, and hearing outcome after PLF closure were compared between the two groups. Numerous similarities in these parame ters were seen in the two groups, and the author concluded that a considerable number of patients with PLF might be missed at exploration, prob ably due to intermittence of PLF or low CSF pressure at the time of surgery.
