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  • Title: Perilymphatic fistula in children with preexisting sensorineural hearing loss.
    Author: Pappas DG, Simpson LC, Godwin GH.
    Journal: Laryngoscope; 1988 May; 98(5):507-10. PubMed ID: 3362013.
    Abstract:
    Progression of preexisting sensorineural hearing loss (SNHL) in infants and children has been considered an indication for fistula exploration: is this approach warranted? On exploring 36 middle ears in 26 such children, we found a perilymphatic fistula (PLF) in four ears (11%). Although there was radiographic evidence of inner-ear deformity in one half of these children, a definite fistula was found in only four of 18 radiographically abnormal ears explored (22%). Even in the four patients with a history of an "event" that could implicate a fistula such as exertion or barotrauma, a fistula was found in only one. There are a number of possible causes for progression of a preexisting SNHL, and surgical exploration of the middle ear should not be recommended on the basis of progression alone. Instead, exploration for a suspected PLF should be strongly considered when there is also a history of an "event", and/or radiographic evidence of inner-ear abnormalities. Even under these conditions, one should be aware that fistulae are not likely to be found.
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