Treatment of Labyrinthine Fistula With Interruption of the Semicircular Canals

Kobayashi, Toshimitsu; Sato, Toshiharu; Toshima, Masaru; Ishidoya, Masako; Suetake, Mitsuko; Takasaka, Tomonori

doi:10.1001/archotol.1995.01890040087015

Cited by 45 publications

(44 citation statements)

References 17 publications

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“…Partial labyrinthectomy in combination with complete cholesteatoma resection has recently been advocated as a way to eradicate the inXammatory process associated with the disease [13,38,39]. Results demonstrated by Magliulo [13] show 14% sensorineural deterioration.…”

Section: Hearing Outcomementioning

confidence: 99%

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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Section: Hearing Outcomementioning

confidence: 99%

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

Stephenson¹,

Saliba

2011

Eur Arch Otorhinolaryngol

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“…However, recent clinical experience and experimental studies have allowed surgical access to the inner ear with preservation of the cochlear function, thus providing a new gateway for the treatment of Ménière's disease (Yin et al, 2008), benign paroxysmal positional vertigo (Parnes and McClure, 1990), cholesteatoma (Kobayashi et al, 1995), skull base tumors (Hirsch et al, 1993), and acoustic neuromas (McElveen et al, 1991). Previous experimental reports support the idea that partial labyrinthectomy can result in maintenance of hearing.…”

Section: Introductionmentioning

confidence: 99%

Effect of vestibular labyrinth destruction on endocochlear potential and potassium concentration of the cochlea

et al. 2010

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“…5-8 A frequency of 5-10% is reported in most studies. 9,10 Very commonly the fistula is seen in the lateral SCC. Sanna and coworkers have classified fistulas as small (0.5 to 1 mm), medium (1 to 2 mm), and large (>2 mm).…”

Section: Discussionmentioning

confidence: 99%

Management of labyrinthine fistula using Surdille flap

Rajashekhar

Shinde

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. Methods: 234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied. Results: The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. Conclusions: Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.

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Treatment of Labyrinthine Fistula With Interruption of the Semicircular Canals

Cited by 45 publications

References 17 publications

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

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

Effect of vestibular labyrinth destruction on endocochlear potential and potassium concentration of the cochlea

Management of labyrinthine fistula using Surdille flap

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