Perilymphatic fistula, usually in the round or oval window, causes a variety of symptoms, including sensorineural hearing loss. Surgical repair of these fistulas has resulted in restoration of hearing in some cases. It has been suggested that surgery must be performed within 2 months of the trauma if improvement in hearing is to occur. This paper presents the case of a patient whose fistula and resulting hearing loss had persisted ten years before surgical repair. Restoration of normal hearing and discrimination of speech occurred in the ear which had previously presented a severe sensorineural hearing loss with no useful discrimination for speech. The authors usge audiologists and otolaryngologists to consider the possibility of fistula in cases of sudden hearing loss, even when years have elapsed since the trauma. Their experience suggests that surgery may be successful in restoring hearing after many years.