Cholesteatoma Causing a Horizontal Semicircular Canal Fistula

Abstract

Horizontal canal fistulas are not uncommon in patients with cholesteatoma. Patients with canal wall down cavities and exposed horizontal canal fistulas develop significant dizziness with wind or suction exposure. Obliteration of mastoid cavities in patients with exposed fistulas can be challenging. We describe a patient with horizontal canal fistula and chronic dizziness from wind exposure who underwent successful mastoid cavity obliteration with preservation of hearing. Patients with horizontal canal fistulas in a canal wall down cavity can be managed with mastoid obliteration for relief of dizziness.

Post-operative vestibular and equilibrium evaluation in patients with cholesteatoma-induced labyrinthine fistulas

“…Our results suggest that obliteration with autograft bone paste after completely removing the cholesteatoma over the labyrinth is a suitable management strategy for relieving vertigo or dizziness, which is consistent with current literature. 16 Furthermore, in the obliteration group, most patients achieved perfectly preserved canal function, and experienced less fatigue, fewer periods of vertigo, faster recovery of equilibrium function and a lower rate of post-operative labyrinthitis or hearing exteriorisation.…”

Analysis of postoperative effects of different semicircular canal surgical technique in patients with labyrinthine fistulas

“…One method advocates leaving the cholesteatoma epithelium to temporarily cover the fistula to avoid inducing further damage to the labyrinthine structure, as the opening of the labyrinth might further damage cochlear function. Another technique advocates the complete removal of cholesteatoma in the fistula area and sealing through the bone or cartilage, as residual cholesteatoma can progress with further bone resorption and destruction, causing further hearing loss; however, there is also a risk of intracranial complications ( Djalilian et al, 2021 ). This study applied Dornhoffer and Milewski (1995) fistula classification and reviewed follow-ups of patients previously treated for labyrinthine fistulas caused by middle ear cholesteatoma to determine the ideal surgical treatment.…”

Symptom: Left-Sided Ear Drainage

“…Cholesteatomas are, at their most basic definition, the occurrence of squamous epithelium (skin) in areas of the temporal bone where it does not belong. That can be in the middle ear, the mastoid, the petrous apex, or other epidural or intracranial locations 1–4 . Rarely, cholesteatomas can occur in the bony ear canal.…”