Artikel
Die Fistel des lateralen Bogenganges als eine Komplikation bei chronischer Otitis media epitympanalis – eine Auswertung aus den Jahren 1999 bis 2005
The Fistula Of The Lateral Labyrinth As A Complication Of A Chronic Otitis Media Epitympanalis – An Evaluation From 1999 To 2005
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Autoren
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Angela Färber
- Klinik für HNO-Heilkunde, Ameos Klinikum, Halberstadt, Germany
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Jörg Langer
- Klinik für HNO-Heilkunde, Ameos Klinikum, Halberstadt, Germany
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Klaus Begall
- Klinik für HNO-Heilkunde, Ameos Klinikum, Halberstadt, Germany
| Veröffentlicht: | 7. September 2006 |
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Gliederung
Text
There are different complications in case of a chronic otitis media epitympanalis to find dependent on the dimension of this disease. 32 patients with a fistula of the labyrinth were treated by surgical therapy from 1999 to 2005.
Out of 32 patients a fistula of the labyrinth was suspected in 16 patients, 2 patients had a paresis of the N. facialis, 30 patients had ear problems and 15 had ear operations in the past.
Intraoperative were found 23 cases of erosion of the osseous, 5 of the membranous labyrinth. 2 patients had a perilymphatic leak. In 15 cases the N. facialis was uncovered, in 7 cases the dura. We used mostly bone meal or tragus cartilage to cover the leakage. Tragus cartilage was regularly taken for the treatment of membranous fistulas. The patients received perioperative always an antibiotic. In 31 cases the antibiosis was continued. 10 patients got a therapy with prednisolon (Stennert-scheme) and 9 a hemodilutive therapy.
6 patients had postoperative a worse hearing, 1 patient a passing paralysis of the N. facialis. The vertigo symptoms improved in 11 cases.
Conclusion: A chronic otitis media epitympanalis can damage in different ways middle and inner ear structures. Therefore the surgeon has to be prepared for complications especially on dehiscence of the labyrinth or other anatomical structures. The ear operation with closure of the labyrinth fistula, antibiotic prophylaxis and the therapy with prednisolon are the standard therapy.
References
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