Cochlear Fistula in Chronic Otitis Media without Cholesteatoma

Kwon, Changyun; Choi, Jeong Hwan; Woo, Hoon Young

doi:10.7874/jao.2017.21.2.112

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…This occurred in 1 patient of our series, when the CF was detected in the scan only after its intraoperative re-evaluation, after a suspect enlargement of oval window was visualised during surgery. Kwon et al 5 also described a similar case in which a CF was suspected during a canal-wall-up tympanomastoidectomy (CWU) and confirmed by intraoperative review of CT images. In addition, it has to be considered that not all patients affected by chronic otitis media without cholesteatoma undergo CT before surgery.…”

Section: Discussionmentioning

confidence: 93%

“…In our series, CF was visible in scans in all cases (100%), even if the fistula located at the inferior border of the oval window was more difficult to identify. However, because of the extreme rarity of CF, radiologists and surgeons may fail to detect it during routine imaging evaluation 5 . This occurred in 1 patient of our series, when the CF was detected in the scan only after its intraoperative re-evaluation, after a suspect enlargement of oval window was visualised during surgery.…”

Section: Discussionmentioning

confidence: 99%

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Management of cochlear fistula and the role of hearing: a five-case report

Falcioni

Govoni

Pasanisi

et al. 2021

Acta Otorhinolaryngol Ital

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SUMMARY Objective Cochlear fistula (CF) is a rare finding, usually associated with extensive middle ear cholesteatoma. There is agreement on the fact that removing the cholesteatoma matrix on a CF exposes the ear to a high risk of sensorineural hearing loss or dead ear. The aim of the study is to describe the presentation, possible treatment strategies and related outcomes for patients with CF in chronic otitis media (COM). Methods The study considers a retrospective case series of patients with CF diagnosis supported by CT-scan and intraoperative/otoscopic evidence. Results Five cases of CF were identified, 4 associated with cholesteatoma and 1 associated with non-cholesteatomatous COM. Two patients presenting with anacusis underwent a subtotal petrosectomy. Two patients with useful hearing underwent a radical mastoidectomy in order to preserve the cholesteatoma matrix on the promontorium. One patient with good hearing and COM was treated conservatively. Conclusions Conservative management should be considered for rare cases of CF in COM with residual hearing. Matrix preservation through radical/modified radical mastoidectomy is strongly advised in the presence of useful preoperative bone conduction. Subtotal petrosectomy should be considered the preferred option in presence of cholesteatoma with preoperative profound hearing loss.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Management of cochlear fistula and the role of hearing: a five-case report

Falcioni

Govoni

Pasanisi

et al. 2021

Acta Otorhinolaryngol Ital

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“…In support of the hypothesis that inflammation causes cochlear fistulae, Zinis et al [15] reported that patients with non-cholesteatoma cochlear fistulae had a perforated tympanic membrane and thickened tympanic chamber mucosa, and pathological examination of the middle ear mucosa showed sclerotic granulation tissue. Kwon et al [16] also reported that repeated mechanical stimulation with a cotton swab induced bony remodeling in the cochlear promontory in a patient with a non-cholesteatoma cochlear fistula accompanied by perforation of the tympanic membrane and granulation tissue. In addition, Kubota [17] reported that adhesive otitis media was involved in 4 out of 5 cases of non-cholesteatoma cochlear fistula, suggesting that an adhesive tympanic membrane may contribute to fistula formation.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Abscess Induced by Cochlear Fistula due to Chronic Suppurative Otitis Media

Shibamiya

Yamauchi

Kuratomi

et al. 2023

ORL

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Cochlear fistulas with cholesteatoma as the primary disease have been reported frequently in the relevant literature. However, there are no reports of cochlear fistula without cholesteatoma due to chronic suppurative otitis media with intracranial complications. We report a case of cochlear fistula due to chronic otitis media that was diagnosed after the onset of a cerebellar abscess. The patient was a 25-year-old man with severe autism. He was admitted to our hospital with otorrhea from his left ear, emesis, and impaired consciousness. Computed tomography (CT) of the head showed left suppurative otitis media, left cerebellar abscess, and brainstem compression due to hydrocephalus. Right extra-ventricular drainage and brain abscess drainage were urgently performed. The next day, foramen magnum decompression and abscess drainage with partial resection of the swollen cerebellum were performed for decompression purposes. He was subsequently treated with antimicrobial therapy, but magnetic resonance imaging of the head showed an increase in the size of the cerebellar abscess. Re-examination of the temporal bone CT scans revealed a bony defect in the left cochlear promontory angle. We assumed that the cochlear fistula was responsible for the otogenic brain abscess. Thus, the patient underwent surgical closure of the cochlear fistula. After the operation, the cerebellar abscess lesion gradually shrank, and his general condition stabilized. Cochlear fistula should be considered in the management of patients with inflammatory middle ear disease associated with otogenic intracranial complications in the middle ear.

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Cochlear Fistula in Chronic Otitis Media without Cholesteatoma

Cited by 2 publications

References 12 publications

Management of cochlear fistula and the role of hearing: a five-case report

Management of cochlear fistula and the role of hearing: a five-case report

Cerebellar Abscess Induced by Cochlear Fistula due to Chronic Suppurative Otitis Media

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