gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

Deutsche Gesellschaft für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie e.V. (DGHNOKHC)

ISSN 1865-1038

Hearing preservation in patients with labyrinthine fistula

Poster

  • 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

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2010;6:Doc77

DOI: 10.3205/cpo000570, URN: urn:nbn:de:0183-cpo0005709

Published: April 22, 2010

© 2010 Gocea et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Abstract

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.