Cholesteatoma labyrinthine fistula: prevalence and impact

Abstract

Labyrinthine fistula must be ruled out prior to ear surgery, particularly in cases of posterior epitympanic or two-route cholesteatoma. Computed tomography is a good diagnostic modality for lateral semicircular canal fistula. Sensorineural hearing loss can occur post-surgically, even in previously unaffected patients despite the technique employed.

“Sandwich technique” enables preservation of hearing and antivertiginous effect in cholesteatomatous labyrinthine fistula

“…Nowadays, most authors underline that the decision on preservation of posterior canal wall should not be determined by the presence of LF but should depend on many factors including hearing status of the operated and contralateral ear, location and extension of the cholesteatoma, coexistence of other complications, patient's age and general condition [3,5,12]. However, when we analyze results presented in the latest literature, it turns out that CWD seems to be preferred technique in LF cases (Table 4) [1,5,[13][14][15][16]. While in some departments CWD is still the method of choice [15], detailed analysis shows that most surgeons choose the approach that primarily enables them radical removal of the cholesteatoma.…”

“…However, when we analyze results presented in the latest literature, it turns out that CWD seems to be preferred technique in LF cases (Table 4) [1,5,[13][14][15][16]. While in some departments CWD is still the method of choice [15], detailed analysis shows that most surgeons choose the approach that primarily enables them radical removal of the cholesteatoma. Although in our study group, 50% of patients were treated by CWD technique, we underlined that the choice of the method was dependent on cholesteatoma related factors and was not determined by the presence of LF itself.…”

Labyrinthine fistula secondary to cholesteatoma: a video demonstration

“…This can proceed to involve the membranous labyrinth. 1 Causes include surgery, trauma, barotrauma, cholesteatoma and even noise exposure. This results in vertigo, hearing loss and tinnitus.…”

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“…Because of its anatomical location, the lateral semicircular canal is normally involved. As reported in the literature, a fistula of the semicircular canal brings a variable, often high risk of hearing loss until anacusis, due to the damage to the membranous labyrinth [5]. The crucial point is the injury to the endosteum of the canal, while its blue lining is considered safe.…”