causes of perilymph fistula
Perilymph fistula has two main causes: 1  The most common causes of a perlymph fistula is trauma to the head or a sudden change in atmospheric presssure, called barotrauma, usually occurring on an airplane or scuba diving. 2  A perilymph fistula has been seen as a side effect of syphilis or Lyme disease.
In the past, a condition called cholesteatoma was a common cause of perilymph fistula, but this condition is now encountered only rarely because of improved antibiotic treatments. It is possible that there are occasionally fistulae associated with tiny cracks in the bone between the middle and inner ear.