[Perilymphatic fistula: differential diagnosis from Menière's disease].

Records of 77 patients who had surgically proven perilymphatic fistula (PLF) from 1979 through 1988 were reviewed. During this period, 16 patients had a fluctuating hearing loss in association with spells of vertigo. Ten of these patients had been diagnosed as having Menière's disease by at least one otolaryngologist before exploration for PLF. Audio-vestibular functions were compared between these PLF patients and those with classic Menière's disease. The following factors are associated with a high incidence of PLF: (1) Low frequencies hearing loss which has father deterioration within few days; (2) A rapidly fluctuating low frequencies hearing loss with wide variability; (3) Very long duration of positional nystagmus; (4) Absence of canal paresis. PLFs often mimicked Menière's disease, although these patients did not have classic Menière's symptoms. This study emphasizes this overlap.