Perilymphatic Fistula: Surgical Experience in the United States

Abstract

One survey sent to 6953 individual otolaryngologic practices and 106 departments of otolaryngology at teaching hospitals in the United States, and a more limited survey of 75 patients operated on for perilymphatic fistula (PLF) at the House Ear Institute, addressed aspects of managing PLF: Surgical incidence, reliability of diagnostic tests, preoperative observations, and disability after surgery. Of surgeons sampled, 93% estimated incidence of PLF surgery to be ≤1 per 1000 otolaryngologic outpatient visits. The most reliable diagnostic indicators were history, symptomatology, and tympanometric and electronystagmographic fistula tests. About 72% of surgeons reported <4 weeks' average delay before surgery. Most surgeons and patients (≥70%) rated length of disability before return to work, exposure to noise, travel by airplane, swimming, and heavy lifting, at several weeks to several months. Diving was the most restricted activity. Results suggest that incidence of surgery and disability with PFL in the United States is very limited.