Preservation of Post Operative Bone Conduction Hearing after Labyrinthine Fistula Repair in Chronic Otitis Media with Cholesteatoma: A Review of 23 Cases

Abstract

OBJECTIVE: Labyrinthine fistula can lead to hearing loss, dizziness, and intracranial complications. The management of labyrinthine fistula is controversial, and hearing preservation represents a major challenge. In this study, the authors sought to identify factors related to postoperative bone conduction threshold. MATERIALS and METHODS: This retrospective study was conducted using the clinical records of 23 cases operated on for chronic otitis media with cholesteatoma from 2004-2011. Symptoms, physical examination finings, fistula test results, pre-/postoperative bone conduction results, and high-resolution temporal bone computed tomograpghy and intraoperative findings were evaluated. RESULTS: The most common symptom at presentation was hearing disturbance, and the most commonly affected site was the lateral semicircular canal. High-resolution temporal bone computed tomograpghy was found to be much more precise and effective at fistula detection than the fistula test. CONCLUSION: Postoperative hearing results are not affected by fistula location, size, or number. Complete resection at the site of a cholesteatomatous labyrinthine fistula is the treatment of choice.