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Chronic Otitis Media
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
George G. Browning, Justin Weir, Gerard Kelly, Iain R.C. Swan
Labyrinthine fistula can be caused by active mucosal COM or cholesteatoma. The lateral semicircular canal is the most commonly affected site and the reported incidence of fistula formation is 4–13% of all cases.89 Histologically, cholesteatoma matrix or granulation tissue becomes apposed to the endosteum of the inner ear or directly to the membranous labyrinth. In many fistulae reactive inner ear changes are absent thus a protective walling off phenomena appears to occur (Figure 83.8). The margins of some labyrinthine fistulae show evidence of new bone formation and this probably explains the clinical observation that many fistulae show spontaneous bony closure after removal of the offending cholesteatoma or granulation tissue.
Neurology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Constant with aural symptoms:1 Chronic otitis media with labyrinthine fistula.
Cholesteatoma surgery with the canal wall up technique combined with mastoid obliteration: results from primary surgery in 230 consecutive cases
Published in Acta Oto-Laryngologica, 2018
Johanna Westerberg, Elina Mäki-Torkko, Henrik Harder
In the consecutive group of 236 cases, CWU was the intention. In six of these, the ear canal had to be removed due to an unfavorable anatomy. In four cases, the en bloc osteoplasty, as described by Mercke, was used. In a further two ears, a CWD operation was necessary. Meeting the inclusion criteria of the study, 230 ear operations in 224 patients were further analyzed. The characteristics of the study group are presented in Table 3. Two hundred (87%) of the procedures were performed by three senior and 30 (13%) mainly by two junior surgeons supervised by senior colleagues. The mean operating time was five hours (SD 1.3). The ossicular chain was preserved in 19 (8%) ears. A PORP was used for reconstruction in 148 (64%) and a TORP in 60 (26%) ears. In all operations autologous bone, ossicular or cortical, was used. In 10 ears, a labyrinthine fistula was encountered. Five of which were reconstructed with a PORP and five with a TORP. Two hundred and twenty-six ears (98%) were followed up one-year postoperatively. The three-year status was obtained in 200 (87%) cases. A normalized anatomy with an intact ear drum was obtained in 90% of the cases. Three (1%) residual cholesteatomas have been detected until April 2016. There were eighteen (8%) recurrent cholesteatomas as presented in Table 2. In total, 56 (24%) revisions were done, as shown in Table 2. Most revisions were performed due to a malfunctioning ossiculoplasty.
Clinical efficacy of the ‘sandwich technique’ in repairing cholesteatoma with labyrinthine fistula
Published in Acta Oto-Laryngologica, 2022
Huanhuan Sun, Taiqin Wang, Liangwen Shi, Suling Zhuang, Jianzhi Liu
Labyrinthine fistula is the most common complication of middle ear cholesteatoma, with an occurrence rate of in 2.4%–16.7% [11–13]. The symptoms of Labyrinthine fistula are atypical, In the study of Hearing loss (90%), ear discharge (65%) and vertigo (50%) are the most frequent presenting symptoms, and a few patients may be accompanied by facial paralysis. Currently, there is still the lack of consensus in the treatment schemes for fistulas.