Treatment of Labyrinthine Fistula

Abstract

\s=b\This cholesteatoma series comprises 84 ears, 81 of which had a labyrinthine fistula and 3 a horizontal semicircular canal opening that arose as a surgical complication. In 49 ears (58.3%), the operation was a primary one; in 35 ears (41.7%), it was a revision. Of all ears, 21 (25%) were deaf preoperatively. The fistula was located in the horizontal canal in 76 ears (90.4%).The matrix was removed in all these ears, and the fistula was covered with fibrin glue and fascia or periosteum. Hearing was preserved in all 57 ears in which matrix removal was carried out as the planned last stage. These included three ears in which the membranous canal was cut deliberately. Surgery that was performed against established rules caused deafness in three ears. Accidental opening of the horizontal canal caused no sensorineural loss in two ears as the fistulas were sealed immediately, while one ear in which the opening was not immediately recognized became deaf. (Arch Otolaryngol Head Neck Surg. 1989;115:804-806) Erosion of the dome of the horizon¬ tal semicircular canal, the most frequent site of a labyrinthine fistula, occurs in an overwhelming majority in patients with a cholesteatoma. Of the many factors that contribute to the erosion, the two most important are collagenase activity of the matrix1 and

Surgical treatment of labyrinthine fistula caused by cholesteatoma

“…Preoperative deafness in our study was present in 15% of patients, which is comparable with data from other reports 18 , 15 , 23 …”

“…The incidence of preoperative deafness in our patients was 15%, which is comparable with results from similar studies 15 , 18 , 23 …”

“…Preoperative deafness in our study was present in 15% of patients, which is comparable with data from other reports. 18,15,23 The location of the fistulas in this study was similar to that found in other studies, 9,10,24 with 88% affecting the HSC. The most commonly found types of fistulas were type II in 63% of patients and type III in 29% of patients.…”

Surgical treatment of labyrinthine fistula in patients with cholesteatoma

“…In this report, 90 per cent patients had a labyrinthine fistula involving this structure. The incidence of patients with multiple fistulae (7 per cent) was consistent with other studies 2 – 8 …”

Imaging of labyrinthine fistula after repair with bone pate

“…The frequent findings of facial nerve dehiscence and stapes erosion are also documented by others . The rate of preoperative sensorineural hearing loss observed in this series is also similar to prior reports . Others find increasing hearing loss in fistula cases correlating with size .…”