Labyrinthine Fistulas: Report of Experiments on the Vital Response to Various Methods of Producing Defects in Bone

Abstract

The literature is replete with references to labyrinthine fistulas occurring during or after chronic suppurations of the temporal bones. Infectious osteitis of the labyrinth produces certain symptoms, which often disappear when the infection subsides. Nyl\l=e' \n1 in 1923, in an exhaustive treatise on the subject, recounted the symptoms presented in some 160 cases. An extensive bibliography accompanied this paper, which on perusal and investigation reveals such a variety of possibilities which may exist with labyrinthine fistulas that adequate explanation for the various symptoms is not as yet possible. Recent work of Dohlman2 has added even more information to labyrinthine function and necessitates revaluation of the present concepts of the physiology of the labyrinth. Reports of experimental research with labyrinthine fistulas were confined to the effects produced on the function of this organ, but few remarks were made about cochlear function. Of possible importance, however, for the problem of fistulization of the otic capsule for defective hearing is the careful observation of the fistulas made with the dissecting microscope magnifying to nine diameters. Holmgren, B\l =a' \r\l =a' \ny and Nyl\l=e'\n have made observations with this instrument and contributed the fact that it can be used for actual operation on the labyrinth. A report of this work was presented in Holmgren's paper in 1922.3 The Gullstrand glasses were described, and the limitation of the technic was designated.