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Vestnik Oto-Rino-Laringologii 2012

[The retrospective clinical study of labyrinthine fistula associated with chronic suppurative otitis media and their treatment].

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E V Garov
R G Antonian
A S Sheremet
E E Garova

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The objective of the present retrospective study was to estimate the efficacy of various surgical techniques employed to treat the patients presenting with chronic suppurative otitis media (CSOM) and concomitant cholesteatoma complicated by labyrinthine fistula. The authors present an overview of the literature concerning diagnostics and results of the surgical treatment of labyrinthine fistula (LF) in the patients with CSOM and concomitant cholesteatoma. The original studies included 157 patients with this condition complicated by labyrinthine fistula. The latter was diagnosed based on the data from medical histories, subjective complaints of the patients, results of otomicroscopy, the presence of fistula symptom verified by the pressure test, results of audiological and vestibulometric studies, and computed tomography (CT) of the temporal bones. Late outcomes of the surgical treatment in the patients presenting with CSOM and concomitant cholesteatoma complicated by LF. All the patients underwent sanitation surgery on the middle ear and revision of the mastoidal portion of the cavity. In 48 of them, cholesteatoma matrix on the fistula in situ was preserved (group 1), in 56 ones the removal of the matrix was followed by plastic correction of labyrinthine fistula using various autogenous tissues (group 2), in 53 patients the cholesteatoma matrix was either removed or preserved with the subsequent sealing of the semicircular canal and selective laser destruction of the labyrinth (LDL) (group 3). 79% of the patients in group 1 had no complaints of dizziness during the postoperative period. There were 78.5% and 96.5% of the patients without such complaints in groups 2 and 3 respectively. The elevation of the hearing threshold following the surgical treatment was documented in 10 (6.4%) patients; it resulted in the deafness in 5 (3%) patients.

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