It is possible that there are occasionally fistulae associated with tiny cracks in the bone between the middle and inner ear. Whatever the cause, PLF is a very rare condition compared to most other causes of dizziness and hearing loss. There are a number of other conditions that can also cause pressure sensitivity such as Meniere's disease and vestibular fibrosis. The symptoms of perilymph fistula may include dizziness, vertigo, imbalance, nausea, and vomiting. Usually however, patients report an unsteadiness which increases with activity and which is relieved by rest.
Some people experience ringing or fullness in the ears, and many notice a hearing loss.
Some people with fistulas find that their symptoms get worse with coughing, sneezing, or blowing their noses, as well as with exertion and activity. Here dizziness is associated with a difference in pressure between ears. This condition remains difficult to document. Head trauma is the most common cause of fistulas, usually involving a direct blow to the ear. Forceful coughing, sneezing or straining as in lifting a heavy object may rarely cause a fistula.