Labyrinthine fistula: an unreported complication of the Grote prosthesis.
OBJECTIVE
To alert the otological surgeon that labyrinthine fistula is a rare and avoidable complication of the Grote hydroxyapatite ceramic external auditory canal (EAC) prosthesis. The reasons for its causation and strategies to prevent its formation are discussed.


METHODS
Case study and retrospective review of the literature.


METHODS
Labyrinthine fistula that occurred after the use of the Grote hydroxyapatite ceramic EAC prosthesis is presented. The literature is reviewed retrospectively for various methods of reconstruction of the EAC following canal wall down mastoidectomy. Strategies and principles are outlined to avoid complications associated with reconstruction of the mastoid and EAC.


RESULTS
The Grote hydroxyapatite (HA) prosthesis is a reliable prosthesis for reconstruction of the external auditory canal (EAC) in the absence of a draining mastoid cavity or cholesteatoma and with adequate soft tissue cover. Contact of the medial end of the prosthesis with the lateral semicircular canal must be avoided. Immobilization or rigid fixation and avoidance of infection are essential for optimal prosthesis stability and osseointegration. Covering the prosthesis with vascularized soft tissue appears to be important for the achievement of a successful reconstruction.


CONCLUSIONS
The Grote prosthesis is safe and effective provided it does not contact the lateral semicircular canal, is stabilized, and covered by vesicular tissue, in the absence of infection.
Gadre
A K
AK
Department of Otology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 7777, San Antonio, TX 78229-3900, USA.
Hammerschlag
P E
PE
D017886:Durapatite; D004424:Ear Canal / Q000601:surgery*; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007759:Labyrinth Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects*; D011859:Radiography; D012189:Retrospective Studies
D017886:Durapatite