Perilymphatic fistula (PLF) is caused by leakage of perilymph through an abnormal communication between the inner and middle ear. Conservative treatment is considered in the initial stages; however, exploratory tympanotomy is performed if hearing does not improve or if dizziness persists. Transcanal endoscopic ear surgery (TEES) is considered an appropriate treatment option and is gaining popularity. We report a rare case of traumatic PLF in a 7-year-old male patient, in whom pneumolabyrinth without temporal bone fracture was diagnosed and treated by exploratory tympanotomy using TEES, and review the related research to discuss the usefulness of management using TEES for PLF.

Background and Objectives The combined intratympanic and oral steroid treatment has been accepted as effective treatment strategy for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the treatment protocol of combined treatment for ISSNHL has not been established. In this study, we investigated whether hearing outcome differed according to different starting timing of intratympanic steroid injection (ITSI) in combined treatment for ISSNHL. Subjects and Method Tertiary academic referral center-based retrospective medical records of idiopathic 144 ISSNHL patients who received combined treatment from January 2015 to April 2018 were reviewed. All patients underwent a 2-week oral systemic steroid treatment and multiple ITSI. The hearing results of 3 months after treatment were compared according to the timing of ITSI. Results The mean pure tone audiogram gain was 24.3±23.6 dB. When Siegel's criteria was applied, the overall rate of hearing improvement was 63.9% (92/144). The rate of hearing improvement was significantly higher in women (p=0.043) statistically, and there was a statistically significant lower rate of recovery in the former history of hearing loss (p＜0.01) or otitis media (p＜0.01). Moreover, the shorter the delay between symptom onset and initial ITSI, greater the statistical significance of hearing recovery rate became (p＜0.01). Conclusion The result of this study suggests that early ITSI during combined intratympanic and oral steroid treatment increases the chance of hearing recovery.