title: Endoscope-guided round window fistula repair.
abstract: OBJECTIVE
  Endoscope-guided round window membrane repair was performed to evaluate whether the approach is feasible in the treatment of a round window fistula.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Tertiary care academic center.
  
  
  METHODS
  A 27-year-old man had been scuba diving 6 days previously in the Australian Great Barrier Reefs. He had poor hearing with tinnitus in the left ear and a vertiginous sensation.
  
  
  METHODS
  A myringotomy was incised, and a tympanoscope was introduced into the middle ear cavity. With the patient under general anesthesia, the middle ear and the oval and round window areas were examined with a tympanoscope. In endoscopic visualization, a round perforation could be seen in the round window membrane. After detection of the round window perforation, a small piece of temporal fascia was obtained to seal the membrane perforation.
  
  
  RESULTS
  One month after the operation, the patient's hearing was significantly better. The myringotomy had healed.
  
  
  CONCLUSIONS
  A transmyringeal endoscopic procedure for round window fistula repair is feasible and combines the best features of minimally invasive surgery and aural endoscopy.
authors.affiliation: Department of Otorhinolaryngology, Tampere University Hospital, P.O. Box 2000, FIN-33521, Tampere, Finland.
authors.forename: T S
authors.initials: TS
authors.lastname: Karhuketo
authors.forename: H J
authors.initials: HJ
authors.lastname: Puhakka
mesh_terms: D000328:Adult; D003052:Cochlear Aqueduct / Q000503:physiopathology; D004427:Ear Diseases / Q000503:physiopathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005402:Fistula / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D013506:Otologic Surgical Procedures / Q000379:methods*; D012405:Round Window, Ear / Q000601:surgery*; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000601:surgery