Spontaneous perilymphatic fistula in children.

Treatment of fistulae in children should be targeted at four different problem areas. The surgical intervention of these fistulae is most efficacious in controlling recurrent meningitis, which has not been discussed in this paper, and in the controlling of vestibular symptoms. Whether or not it will stop the progression of hearing loss or restore hearing is not known in a group of patients. It has been documented in this and other reports that the closure of the fistula will in specific cases appear to be associated in time with a stopping of the progression of the hearing loss and is associated also in time with the restoration of hearing function. Various factors must be considered in developing criteria for intervention. A decision to explore the ear should be based on history, audiometric change, vestibular testing including a fistula test, and malformation of bony labyrinth.