title: The intra-operative incidence of Fallopian canal dehiscence during surgery for cholesteatoma: a prospective case-control study and review of the literature.
abstract: OBJECTIVE
  To investigate Fallopian canal dehiscence (FCD) during cholesteatoma surgery.
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  Four hundred and one patients with cholesteatoma and 172 with otosclerosis.
  
  
  METHODS
  Therapeutic.
  
  
  METHODS
  District general hospital.
  
  
  METHODS
  (i) Intra-operative incidence of FCD during (a) surgery for cholesteatoma versus a homogeneous control group (patients with otosclerosis); (b) revision surgery for cholesteatoma as compared to primary surgery. (ii) Intra-operative incidence of a fistula if FCD is present.
  
  
  RESULTS
  Data were prospectively collected and analysed using chi-square tests. FCD was found in 19% of cases versus 5.2% of controls. Intra-operative incidence of (i) FCD during cholesteatoma surgery versus otosclerosis surgery was statistically very highly significant (P < 0.0001, OR = 5.43); (ii) FCD during revision versus primary cholesteatoma surgery was not statistically significant (P = 0.83); and (iii) encountering a fistula in the presence of FCD during cholesteatoma surgery was statistically very highly significant (P < 0.0001, OR = 6.71).
  
  
  CONCLUSIONS
  A surgeon is more likely to encounter FCD during cholesteatoma surgery than in stapes surgery. If during cholesteatoma surgery FCD is found, then a fistula is also more likely to be present, mainly of the semicircular canal. The incidence of FCD is not increased in revision surgery. These findings are very relevant for any otologist undertaking cholesteatoma surgery.
authors.affiliation: Department of ENT, Ipswich General Hospital, Ipswich, UK.
authors.forename: A
authors.initials: A
authors.lastname: Trinidade
authors.forename: M W
authors.initials: MW
authors.lastname: Yung
mesh_terms: D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D014943:Global Health; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D013506:Otologic Surgical Procedures; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*