[Studies of labyrinthine cholesteatoma-related fistulas: report of 22 cases].
OBJECTIVE
To study the incidence, location, pre- and postoperative symptoms (hearing loss, tinnitus, vertigo, facial palsy), preoperative diagnostic imaging, and surgical treatment of labyrinthine fistulae (LF).


METHODS
Retrospective case review.


METHODS
Twenty-two cases of LF over 382 mastoid operations performed in a 168-month period.


METHODS
Clinical, imaging, and surgical correlation of extensive fistulae and bone fistulae.


RESULTS
LF prevalence was 5.8%. The main primary symptoms were otorrhea and hypoacusis. Only four patients presented vertigo as their main complaint. All patients underwent preoperative computed tomographic (CT) scans and preoperative audiometry. LF diagnosis was made before surgery for 100% of patients on the basis of CT scan. A second fistula was, however, misdiagnosed by imaging in two patients. With respect to surgical technique, a canal wall down procedure was performed in 77% and a conservative procedure was performed in 23%. Fistula was located in the horizontal semicircular canal in 100% of cases, and in 9%, a second fistula was operatively diagnosed. In 91% of cases, the matrix was removed, whereas it was left in the course of a canal down procedure in 9%. With a follow-up of 5.7 years, hearing remained unchanged in 80% of patients.


CONCLUSIONS
Surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia is a safe procedure that can help preserve cochlear function. The choice of a canal down procedure would be influenced by cholesteatoma characteristics rather than by the finding of an LF.
Portier
Frédéric
F
Service d'oto-rhino-laryngologie et Chirurgie Cervico-Faciale, CHU de Bicêtre, Le Kremlin-Biĉetre, France.
Lescanne
Emmanuel
E
Racy
Emmanuel
E
Nowak
Catherine
C
Lamblin
Benoit
B
Bobin
Serge
S
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002558:Cerebrospinal Fluid Otorrhea / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002908:Chronic Disease; D007758:Ear, Inner / Q000000981:diagnostic imaging* / Q000601:surgery; D005205:Fascia / Q000637:transplantation; D005260:Female; D005402:Fistula / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000000981:diagnostic imaging; D013703:Temporal Muscle / Q000637:transplantation; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology