Clinical characteristics of patients with cochlear fistulas caused by chronic otitis media with cholesteatoma
- Authors
- Sunwoo W.; Lee S.-Y.; Seong J.; Han Y.E.; Park M.-H.
- Issue Date
- Apr-2020
- Publisher
- AVES
- Keywords
- Cholesteatoma; Classification; Cochlea; Fistula; Otitis media
- Citation
- Journal of International Advanced Otology, v.16, no.1, pp.40 - 46
- Journal Title
- Journal of International Advanced Otology
- Volume
- 16
- Number
- 1
- Start Page
- 40
- End Page
- 46
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/47132
- DOI
- 10.5152/iao.2020.7018
- ISSN
- 1308-7649
- Abstract
- OBJECTIVES: To analyze the clinical characteristics of cochlear fistulas (CFs) and propose a new fistula classification system with regard to the cochlea. MATERIALS and METHODS: A retrospective chart review was conducted between January 2008 and December 2015 to identify patients who had undergone surgery for cholesteatoma with an associated CF. The following data were collected: preoperative symptoms, findings of tem-poral bone computed tomography (TBCT), fistula stage, cholesteatoma classification, surgical technique, and pre-and postoperative pure-tone audiometry. RESULTS: We analyzed a total of 159 patients, out of which 9 (5.7%) were diagnosed with a CF. The average duration of the chronic otitis media was 19.8 years. Cholesteatomas that induced CF rarely existed in the nonaggressive state; recurrent otorrhea was observed in all but one of our subjects. All the patients with CF had a distinct origin of cholesteatoma that developed from the retraction of posterior pars tensa; further, 88.9% cholesteatomas extended to and filled the sinus tympani. Preoperative audiometry revealed total hearing loss in 4 (44.4%) patients. Further, five patients with residual hearing before surgery had stage I fistulas, and the bone conduction thresholds remained stable after surgery. CONCLUSION: Cochlear fistulas were often detected in patients with (1) a history of chronic otitis media (exceeding 10 years), (2) frequently recur-ring otorrhea, and (3) pars tensa cholesteatomas that extended to the posterior mesotympanum and filled the sinus tympani. Such patients can suffer from potentially severe and irreparable sensorineural hearing loss. © 2020, AVES. All rights reserved.
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