This is a video demonstrating a surgical repair of a perilymph fistula. In this surgery performed by Dr. Hamid Djalilian, the oval window and round window areas are grafted. The patient developed a fistula after a fall and had symptoms of dizziness with blowing of the nose, and vertigo with loud sounds, coughing, sneezing, baring down, etc. This surgery is performed when a blood patch procedure (first described by Dr. Djalilian) is only temporarily effective. This surgery is performed at the University of California, Irvine Medical Center.