H�rergebnisse nach Verschluss von Labyrinthfisteln bei Patienten mit Cholesteatomen

Stripf, Tobias; Jecker, Peter; Maurer, JT; Mann, Wolf J.

doi:10.1007/s00106-002-0711-z

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…There is no clear consensus as to which type is most common, with different studies reporting and using different classifications. In general, higher grade fistulas such as type II and III are found to be diagnosed and reported more often, and some authors consider only types II and III as real fistulas [ 13 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

Thangavelu

Weiß

Mueller-Mazzotta

et al. 2021

Eur Arch Otorhinolaryngol

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Introduction During surgery in patients with labyrinthine fistula the mandatory complete removal of the cholesteatoma while preserving inner ear and vestibular function is a challenge. Options so far have been either the complete removal of the cholesteatoma or leaving the matrix on the fistula. We evaluated an alternative “under water” surgical technique for complete cholesteatoma resection, in terms of preservation of postoperative inner ear and vestibular function. Methods From 2013 to 2019, 20 patients with labyrinthine fistula due to cholesteatoma were operated. We used the canal wall down approach and removal of matrix on the fistula was done as the last step during surgery using the “under water technique”. The pre and postoperative hearing tests and the vestibular function were retrospectively examined. Results There was no significant difference between pre and post-operative bone conduction thresholds; 20% experienced an improvement of more than 10 dB, with none experiencing a postoperative worsening of sensorineural hearing loss. Among seven patients who presented with vertigo, two had transient vertigo postoperatively but eventually recovered. Conclusion Our data show that the “under water technique” for cholesteatoma removal at the labyrinthine fistula is a viable option in the preservation of inner ear function and facilitating complete cholesteatoma removal.

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Section: Discussionmentioning

confidence: 99%

Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

Thangavelu

Weiß

Mueller-Mazzotta

et al. 2021

Eur Arch Otorhinolaryngol

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Prognostic indicators of hearing after complete resection of cholesteatoma causing a labyrinthine fistula

Stephenson¹,

Saliba

2011

Eur Arch Otorhinolaryngol

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The objectives of this study are (1) to evaluate hearing change after complete cholesteatoma resection in the setting of a labyrinthine fistula, (2) to assess the sensitivity and specificity of the preoperative CT-scan in diagnosing a labyrinthine fistula, and (3) to determine the correlation between the type of the labyrinthine fistula and its radiologic size. A retrospective chart review of all patients operated for cholesteatoma between 2004 and 2009 was conducted. Primary outcome was defined as the average variation in bone conduction thresholds (BCTs) as well as speech discrimination score (SDS) after total excision of cholesteatoma causing a labyrinthine fistula. We reviewed all preoperative CT-scans and operative notes to assess sensitivity and specificity for the diagnosis of a labyrinthine fistula. Results show that 317 patients underwent mastoidectomy for cholesteatoma. Twenty-eight patients were found to have 32 labyrinthine fistulas caused by cholesteatomatous disease affecting the lateral semi-circular canal (SCC) (n = 25), the superior SCC (n = 5), the posterior SCC (n = 1) and the footplate (n = 1). Postoperative BCT and SDS (24.5 dB; 86.6%) were neither clinically nor statistically different from preoperative levels (23.2 dB; 87.5%) (p = 0.35). Sensitivity and specificity of the preoperative high resolution 0.55 mm cuts CT-scan was 100%. With a fistula of 3.55 mm in the axial plan, a membraneous fistula must be suspected with a sensitivity of 66% and a specificity of 71%. Complete matrix resection without suctioning at the site of a cholesteatomatous labyrinthine fistula is a safe and effective management option. High-resolution preoperative CT-scan is very precise in diagnosing labyrinthine fistula and its radiologic size helps to predict the type of the fistula.

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H�rergebnisse nach Verschluss von Labyrinthfisteln bei Patienten mit Cholesteatomen

Abstract: The outcome of cholesteatoma resection and closure of the fistula in a single operation was good. Perilymphatic leakage seems to be predictive of a poorer result in terms of hearing.

Cited by 2 publications

References 11 publications

Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

Prognostic indicators of hearing after complete resection of cholesteatoma causing a labyrinthine fistula

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