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. 2019 May;31(104):167-172.

Labyrinthine Fistulae in Squamosal Type of Chronic Otitis Media: Therapeutic Outcome

Priyanka Misale  1 , Anjali Lepcha  1 , Ramanathan Chandrasekharan  2 , Manusrut Manusrut  3
Affiliations

Labyrinthine Fistulae in Squamosal Type of Chronic Otitis Media: Therapeutic Outcome

Priyanka Misale et al. Iran J Otorhinolaryngol. 2019 May.

Abstract

Introduction: Labyrinthine fistulae (LF) are the common complications of chronic otitis media (COM) of squamosal variety. The final therapeutic outcome of this condition is to preserve the cochlear and vestibular functions. Herein, we present the data of the cases managed at our institute with respect to their presenting complaints, adopted therapeutic approaches and outcomes.

Materials and methods: A retrospective chart review was conducted on all cases with COM squamosal type in adult patients. A total of 275 patients were reviewed, out of whom 30 cases had LF. The results were mainly studied with respect to the postoperative improvement of hearing and vertigo.

Results: The incidence rate of LF in the present study was obtained at 10.9%. Only 50% of the cases had the symptoms of vertigo. Furthermore, positive fistula test was elicited in 3.3% of the cases. All cases undergoing preoperative imaging were diagnosed successfully. In addition, 42.85% of the cases had profound hearing loss preoperatively, which sustained after the operation. However, 47.61% of the cases showed an improvement of at least ≥ 10 dB in the air-bone gap. Out of the 15 LF cases with vertigo as the main complaint, only 11 cases referred for follow-up. In this regard, 63.63% of the cases had no postoperative vertigo symptoms.

Conclusion: Patients with LF may not have complaints of vertigo and a positive fistula sign upon admission. Pre-operative imaging facilitates the diagnosis of this condition. The removal of the matrix under constant irrigation, followed by repair with bone wax and/or autologous tissue, is sufficient to preserve the cochlear and vestibular symptoms postoperatively.

Keywords: Cholesteatoma; Hearing Loss; Labyrinth diseases; Middle Ear; Vertigo.

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Figures

Fig 1
Fig 1
A: Cholesteatoma matrix covering the fistula site on the lateral semicircular canal, B: Matrix clearance off the fistula site under continuous irrigation
Fig 2
Fig 2
Scatter plot showing preoperative and postoperative bone conduction threshold
See this image and copyright information in PMC

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References

    1. McCabe BF. Labyrinthine fistula in chronic mastoiditis. Ann Otol Rhinol Laryngol . 1983;93(suppl 112):138–41. - PubMed
    1. Sanna M, Zini C, Bacciu S, Scandellari R, Delogu P, Jemmi G. Management of the labyrinthine fistula in cholesteatoma surgery. ORL J OtorhinolaryngolRelat Spec. 1984;46:165–72. - PubMed
    1. Pulec JL. Labyrinthine fistula from cholesteatoma: surgical management. Ear Nose Throat J. 1996;75:143–8. - PubMed
    1. Magliulo G, Terranova G, Varacalli S, Sepe C. Labyrinthine fistula as a complication of cholesteatoma. Am JOto. 1997;18:697. - PubMed
    1. Manolidis S. Complications associated with labyrinthine fistula in surgery for chronic otitis media. Otolaryngol Head Neck Surg. 2000;123:733–7. - PubMed

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