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Arch Otolaryngol Head Neck Surg. 1998;124:1279-1281.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hypothesis

A 5-year-old child with fluctuating sensorineural hearing loss (SNHL), normal computed tomographic findings, and no history of trauma or craniofacial abnormalities should undergo middle ear exploration for a perilymphatic fistula.

BACKGROUND

The evaluation and management of SNHL in a child, especially sudden or fluctuating hearing loss, remains a challenging and controversial task. The differential diagnosis in these situations must often be exhaustive. Depending on the age of the child, the clinician must consider etiologies such as viral labyrinthitis, autoimmune disease, hereditary hearing loss, Ménière disease, an acoustic neuroma, vascular disease, congenital syphilis, malingering, and a perilymphatic fistula (PLF).^1-3 Based on the information provided, the primary concern is a PLF, defined as an abnormal connection between the inner ear and the middle ear cleft that allows the escape of perilymphatic fluid.⁴ Perilymphatic fistulae have been categorized into acquired and congenital types^4-5: acquired PLFs are associated with a traumatic event or previous . . . [Full Text of this Article]

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