Vivar-Acevedo E, Sánchez-Castro GF

Language: Spanish
References: 11
Page: 289-295
PDF size: 583.90 Kb.

ABSTRACT

Labyrinthine fistulae represent a well-known complication of chronic otitis media with cholesteatoma. Its estimated frequency is close to 10%. They are an abnormal communication between inner ear membranous system and middle ear space. According to the erosion they can be classified by defect length or depth. They are associated with chronic infection, vestibular symptoms and sensorial hearing loss. The objective of this review is to provide an actualized descriptionof proper classification and management, using three cases recently presented at our institution. The most important factor for opportune diagnosis still remains a high level of suspicious. Fine cut computed tomography is an invaluable tool for diagnosis. Treatment is based on four factors: patient’s hearing level, accounting contralateral ear; skills and experience of the surgeon; size and location of fistulae and the mechanism of erosion caused by cholesteatoma. The lack of a standardized accepted classification system makes published data related to fistulae management hard to interpret. Classically they have been treated in a conservative way, by leaving cholesteatoma matrix over the defect site to seal it. However, recent studies show that the complete removal of cholesteatoma matrix and defect closure are more effective measures for disease control. This review is made to provide current and accurate information regarding management of labyrinthine fistulae.

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