Spontaneous perilymphatic fistula.

Sudden hearing loss from spontaneous perilymphatic fistula in a child managed by prompt surgical intervention and with recovery of hearing has not previously been reported. The historical and contemporary theories of fistula formation are reviewed. A child with spontaneous oval window rupture associated with a congenital malformation of the stapes and cochlear aqueduct is described together with his complete recovery of hearing following surgical repair. Some rationales explaining the mechanism of oval window rupture in this patient are suggested.