In most instances it is a tear or defect in one or both of the small, thin membranes between the middle and inner ears. These membranes are called the oval window and the round window. A third possible location is between in the bone of the ear, the otic capsule. A number of other conditions can also cause pressure sensitivity. The symptoms of perilymph fistula may include dizziness, vertigo, imbalance, nausea, and vomiting.
Patients typically report an unsteadiness that increases with activity and is relieved by rest.
Some people experience ringing or fullness in the ears, and many notice a hearing loss. Other people with fistulas find that their symptoms get worse with coughing, sneezing, or blowing their noses, as well as with exertion and activity. Head trauma, usually involving a direct blow to the ear, is the most common cause of fistulas. Forceful coughing or sneezing may rarely cause a fistula. Ear surgery, particularly stapes surgery, often causes fistula.