People suffering from perilymphatic fistula (PLF) often feel frustrated as they may look fairly normal to other people while they do not feel well at all and they may find it hard to explain how they feel to others. These people have to learn to cope with the debilitating symptoms that accompany a perilymphatic fistula like persistent dizziness. If you have sustained a blow to the head and suffer from vertigo, get vertigo treatment today. 1

What is a perilymphatic fistula?

A perilymph fistula is a leak of perilymph in one or both of the very thin membranes of the oval or round window of the ear that separates the inner ear’s fluid-filled perilymphatic space from the middle ear which is normally filled with air. In other words, the perilymphatic fistula is a small opening through which fluid (perilymph) leaks into the middle ear compartment.

Under normal circumstances, changes in air pressure in the middle ear would not affect your inner ear. However, when there’s a fistula, the inner ear will be affected and the balance and hearing structures will become stimulated causing the symptoms that go along with a perilymphatic fistula. 1,2

The diagnosis of PLF is extremely challenging and it commonly needs to be done during an operation. 3

What are the symptoms that accompany a perilymphatic fistula?

Some debilitating symptoms go along with a perilymphatic fistula and many people experience even worse symptoms with a change in altitude, for instance during air travel, in fast elevators and during travel in the mountains. 1

The symptoms include: 1,4

What causes perilymphatic fistula?

PLF is classified as congenital or acquired, however, it is usually not present from birth. A perilymphatic fistula is most commonly caused by trauma to the head like a blow to the head or a whiplash injury. It may also be caused by an object that perforates the ear drum or even an “ear block” which happens when an airplane descends or during scuba diving. Perilymphatic fistulas are also known to develop after the pressure in the skull increases rapidly (for instance during labour or weight lifting or simply when sneezing or coughing). 1,3,4

Treatment of a perilymphatic fistula

After any traumatic injury to the head that leads to the sudden onset of dizziness or hearing loss, a person is advised to restrict any physical activity for at least 7 to 14 days. If after this waiting period there is no improvement, tests are ordered and if PLF is found, surgery is considered. Seeing as bending, lifting and straining can worsen the symptoms, someone who is awaiting surgery should avoid these activities. 1

PLF is no walk in the park, so if you suspect yourself or someone else of having PLF, get vertigo treatment as soon as possible. Call Brain Hub on 1300 770 197 now!



  1. Vestibular disorders association. What is perilymph fistula? Available from:
  2. Hornibrook J. A balance test for chronic perilymph fistula. Sept 2012; 163691:1687-9201.
  3. Zolnourian A, Paramanathan V. Perilymphatic fistula following a closed head injury. J Trauma Treat. Jan 2013; 2(4).
  4. Hornibrook J. Perilymph Fistula: Fifty Years of Controversy. ISRN Otolaryngology Jun 2012; 2012: 281248.

Dr Carlo Rinaudo (Chiropractor and PhD candidate) is the clinic director of Brain Hub, a clinic in Sydney focussed on helping people with dizziness and vertigo conditions, poor balance, whiplash and concussion symptoms.

The clinic and its practitioners use a range of modalities to help assess and manage these conditions and/or symptoms. Vestibular rehabilitation therapy and other brain-based therapies are primarily utilised, along with standard Chiropractic and physical therapy techniques.

The growing evidence showing support for the management of these conditions comes primarily from the physical therapy and clinical neuroscience fields, rather than chiropractic specific. Fortunately, Dr Rinaudo with post-graduate training both in Australia and from overseas is experienced to translate this knowledge into clinical practice. Additionally, he is currently undertaking a PhD from the University of New South Wales (UNSW) and Neuroscience Research Australia (  in Vestibular Therapy, more specifically clinical trials on how to help people with dizziness and vertigo conditions. He is working alongside leading researchers and Neurologists in the field. Additionally, the benefits expected from his PhD research will be used to further validate the use of vestibular rehabilitation therapy for other related conditions like whiplash and concussions.

Dr Rinaudo is a frequent speaker at national events, as well as lecturer in the field of vestibular rehabilitation and dizziness conditions to other health practitioners.