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  • Title: [Diagnosis and surgical management of labyrinthine fistula caused by cholesteatoma].
    Author: Jia M, Qin Z.
    Journal: Lin Chuang Er Bi Yan Hou Ke Za Zhi; 2005 Jul; 19(13):592-3. PubMed ID: 16200828.
    Abstract:
    OBJECTIVE: To describe the clinical presentation and surgical management of patients with labyrinthine fistula caused by cholesteatoma. METHOD: Retrospective study of the clinical presentation, surgical technique and hearing outcomes based on 350 cases of chronic otitis media with cholesteatoma was carried out. Twenty three patients (6.6%) with labyrinthine fistula were found, in 9 ears (39.1%) the preoperative pure tone average for bone conduction was greater than normal, including 2 cases of analysis. Subjective vertigo or dizziness occurred in 11 patients (47.8%), the fistula test was positive in 5 patients (21.7%). Preoperative high resolution computed tomography (HRCT) scans were performed on all patients and 13 patients (57%) were detected to be with labyrinthine fistula in imaging. During the operation we found the lateral semicircular canal was the most commonly affected site (20/23), at the same time dehiscence of the facial canal was observed in 8 patients. RESULT: The patients were followed-up for an average time of 2 years, dizziness disappeared completely in 22 cases and there were no significant changes in their bone conduction thresholds. CONCLUSION: Labyrinthine fistulae are usually caused by cholesteatoma. There are no reliable methods at present for preoperative diagnosis HRCT is useful but its limitations should also be recognized. The verification of a labyrinthine fistula can be definitively established only at the time of surgery. Completely remove the cholesteatoma matrix can be the treatment of choice in these cases.
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