Endoscopic Repair of Traumatic Perilymphatic Fistula in Children: A Case Series

Traumatic perilymphatic fistula (PLF) is an uncommon cause of acute vestibular symptoms and hearing loss following head injury in children. We describe the management of 3 pediatric patients with traumatic PLF using an endoscopic ear surgery (EES) approach. Three pediatric patients with traumatic PLF underwent repair via an EES approach between August and October 2018. Patients included a 14-year-old female (oval window), a 13-year-old male (round window), and a 10-month-old male (oval and round window). Ossicular chain injury was identified and repaired in 2 patients. The 10-month-old patient required a second-stage surgery that included lumbar drain placement and a post-auricular, endoscopic-assisted approach due to an especially brisk leak. All patients had complete resolution of vestibular symptoms post-operatively with no recurrence at a mean follow-up of 8.3 months. Traumatic PLF can be safely and effectively diagnosed and managed via an EES approach in children, though an endoscopic-assisted approach may be necessary in select cases due to factors such as patient age and leak severity.