Stapedectomy--fistula repair

Abstract

Perilymphatic fistulae have been proposed to occur most frequently on the short side of the graft in stapedectomized patients. The usual recommendation in fistula cases has been replacement of the entire prosthesis by a piston and tissue graft complex. In this case the stapedectomy had been performed, using a polyethylene Shea strut, 15 years previously. The air-bone gap had been closed during this entire period. A fistula was suspected after sudden hearing loss developed after barotrauma. At the time of exploratory tympanotomy, a fistula was noted on the long side of the oval window graft. It was elected to leave the polyethylene tube prosthesis in place because of its solid fixation, both laterally and medially. The fistula was closed by subcutaneous tissue graft.