Management of labyrinthine fistula in chronic otitis with cholesteatoma: case series.

Abstract

Labyrinthine fistula is a complication of ear cholesteatoma that increase the risk of sensorineural hearing loss. The management of the fistula must be done contextually with mastoidectomy by: leaving cholesteatoma matrix over the fistula, or remove the matrix reconstructing the defect. Objective: analysis of the two techniques to treat labyrinthine fistula. Methods: retrospective review with case series analysis. Results: a labyrinthine fistula was present in 14% of cholesteatoma patients; CT scan was pre-dictive in all cases; the hearing preservation was obtained with both techniques; a re-currence was detected only in one case; postoperative nystagmus incidence was higher in those cases with matrix left in situ and when the size of the fistula was lar-ger than 2 mm. Conclusions: the labyrinthine fistula have to be treated contextually with cholesteatoma removal, both techniques had good postoperative hearing preser-vation rate. The postoperative vertigo with nystagmus is more frequent in larger fistu-las.