Perilymph fistulae: variability of symptoms and results of surgery.

A perilymphatic fistula of a labyrinthine window may initially present with various cochlear or vestibular symptoms. Vestibular perilymph leaks can occur spontaneously with or without hearing loss and are most readily diagnosed by a positive Hennebert's sign. Surgical correction is indicated and should initially consist of grafting of the perilymph leak. A significant incidence of recurrence warrants further investigation of grafting materials and techniques.