Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T04:29:53.097Z Has data issue: false hasContentIssue false

Surgical treatment of labyrinthine fistula in patients with cholesteatoma

Published online by Cambridge University Press:  22 May 2009

Y Ueda*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Kurita
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
Y Matsuda
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
S Ito
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Yoshihisa Ueda, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume 830-0011, Japan Fax: +81 942 37 1200 E-mail: [email protected]

Abstract

Labyrinthine fistula is one of the most common complications of chronic otitis media associated with cholesteatoma. The optimal management of labyrinthine fistula, however, remains controversial. Between 1995 and 2005, labyrinthine fistulae were detected in 31 (6 per cent) patients in our institution. The canal wall down technique was used in 27 (87 per cent) patients. The cholesteatoma matrix was completely removed in the first stage in all patients. Bone dust and/or temporalis fascia was inserted to seal the fistula in 29 (94 per cent) patients. A post-operative hearing test was undertaken in 27 patients; seven (26 per cent) patients showed improved hearing, 17 (63 per cent) showed no change and three (11 per cent) showed a deterioration. The study findings indicate that there are various treatment strategies available for cholesteatoma, and that the treatment choice should be based on such criteria as auditory and vestibular function, the surgeon's ability and experience, and the location and size of the fistula.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Sheehy, JL, Brackmann, DE. Cholesteatoma surgery: management of the labyrinthine fistula – report of 97 cases. Laryngoscope 1979;89:7887CrossRefGoogle ScholarPubMed
2Copeland, BJ, Buchman, CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol 2003;24:5160Google Scholar
3Gersdorff, MCH, Nouwen, J, Decat, M, Degols, JC, Bosch, P. Labyrinthine fistula after cholesteatomatous chronic otitis media. Am J Otol 2000;21:32–5CrossRefGoogle ScholarPubMed
4Parisier, SC, Edelstein, DR, Han, JC, Weiss, MH. Management of labyrinthine fistulas caused by cholesteatoma. Otolaryngol Head Neck Surg 1991;104:110–15Google Scholar
5Merhy, AS, Suarez, MAB. Surgical treatment of labyrinthine fistula caused by cholesteatoma. Otolaryngol Head Neck Surg 2000;122:739–42CrossRefGoogle Scholar
6Sanna, M, Zini, C, Gamoletti, R, Taibah, AK, Russo, A, Scandellari, R. Closed versus open technique in the management of labyrinthine fistulae. Am J Otol 1988;9:470–5Google ScholarPubMed
7Dornhoffer, JL, Milewski, C. Management of the open labyrinth. Otolaryngol Head Neck Surg 1995;112:410–14CrossRefGoogle ScholarPubMed
8Palva, T, Ramsay, H. Treatment of labyrinthine fistula. Arch Otolaryngol Head Neck Surg 1989;115:804–6CrossRefGoogle ScholarPubMed
9Gacek, RR. The surgical management of labyrinthine fistulae in chronic otitis media with cholesteatoma. Laryngoscope 1974;10:119Google Scholar
10Kobayashi, T, Sato, T, Toshima, M, Ishidoya, M, Suetake, M, Takasaki, T. Treatment of labyrinthine fistula with interruption of the semicircular canals. Arch Otolaryngol Head Neck Surg 1995;121:469–73CrossRefGoogle ScholarPubMed
11Herzog, JA, Smith, PG, Kletzker, GR, Maxwell, KS. Management of labyrinthine fistulae secondary to cholesteatoma. Am J Otol 1996;17:410–15Google Scholar
12Hakuba, N, Hato, N, Shinomori, Y, Sato, H, Gyo, K. Labyrinthine fistula as a late complication of middle ear surgery using the canal wall down technique. Otology Neurotology 2002;23:832–5CrossRefGoogle ScholarPubMed
13Rizer, FM, House, JW. Perilymph fistulas: the House Ear Clinic experience. Otolaryngol Head Neck Surg 1991;104:239–43CrossRefGoogle ScholarPubMed