Management of Secondary Endolymphatic Hydrops Associated with Perilymphatic Fistula

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We report a 26-year-old male patient with vertiginous sensation and sensorineural hearing loss of high frequency in his left ear after breathing strongly through his nose and hearing a pop sound. Because of his persistent dizzy spells and progressive hearing loss, we diagnosed perilymphatic fistula and performed an exploratory tympanotomy. We closed both oval and round windows with fascia, although we could not find any obvious fistula during surgery, resulting in reduction of dizziness and prevention of progressive hearing loss.One year after the operation, the patient came to complain about episodic vertigo with left fluctuating hearing loss. His audiogram showed left low tone sensorineural hearing deterioration and a glycerol test revealed endolymphatic hydrops in the left ear. we diagnosed secondary endolymphatic hydrops associated with perilymphatic fistula and performed endolymphatic sac drainage and steroid-instillation surgery. Follow-up for 6 months showed complete relief from vertigo and 11.3dB hearing improvement.