gms | German Medical Science

81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

12.05. - 16.05.2010, Wiesbaden

Hearing preservation in patients with labyrinthine fistula

Meeting Abstract

  • corresponding author Anamaria Gocea - UMF CLUJ-NAPOCA, Cluj-Napoca, Romania
  • Brigida Vidal - Hospital Clinic, Barcelona, Spain
  • Charlotte Panuschka - Hospital Clinic, Barcelona, Spain
  • Manuel Bernal-Sprekelsen - Hospital Clinic, Barcelona, Spain
  • Pilar Epprecht - Hospital Son Dureta, Palma de Mallorca, Spain

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hnod294

DOI: 10.3205/10hnod294, URN: urn:nbn:de:0183-10hnod2945

Veröffentlicht: 22. April 2010

© 2010 Gocea et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The management of labyrinthine fistula has been controversially debated.

Methods: Retrospective study on 28 patients with labyrinthine fistulae found during cholesteatoma surgery; in all cases total matrix removal was performed, the fistula covered with bone dust, periostium and/or cartilage. 23 patients received intraoperatively a high dosage of iv steroids about 15 minutes before handling the fistula. As outcome measurements we compared the preoperative and postoperative bone conduction to assess the inner ear function.

Results: The fistula was located on the lateral semicircular canal in 22 patients (78.57%) and at the oval window in 5; one patient had a double localization (superior and lateral semicircular canals). 5 patients (17.85%) had a fistula type I, 8 had type IIa (28.5%), 4 patients (14.4%) presented a type IIB fistula and 6 had a type III (21.40%). Preoperatively the bone conduction displayed an average threshold of 34 dB. Patients treated by steroids showed a preserved or improved bone conduction in almost 70%. Patients with fistulas of the OW and fistulae type IIa on the LSC treated by cortisone experienced a good sensorineural hearing outcome (preservation or significant improvement of the inner ear function) whilst the auditory results for groups IIb and III are inconclusive. Five patients did not receive steroids. Three of them developed a partial sensorineural hearing loss, one got deaf and in one the preoperative hearing level remained unchanged.

Conclusion: Matrix removal over the fistula after a high dosage metilprednisolone administration followed by repair seems to be helpful in preventing permanent inner ear damage. In patients with fistulae on the oval window or type IIa fistulae of the LSC the threshold for bone conduction could be improved.