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Surgical management of labyrinthine fistula with cholesteatoma

Published online by Cambridge University Press:  29 June 2007

Peter K. Gormley
Peter K. Gormley*
Affiliation:
Bellfast
*
Peter K. Gormley, FRCS, FRCSI, DLO, Eye and Ear Clinic, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern IrelandBT12 6BA.
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Summary

From 684 cases of ear surgery for cholesteatoma performed by one surgeon, 35 had labyrinthine fistulae (incidence 5.1 per cent). Of these fistulae, 79 percent involved the lateral semicircular canal only; the other sites involved were the other semicircular canals and the cochlea. The fistula test was positive in 54 per cent of cases overall, but in 80 per cent with an extended site fistula (ESF). Three surgical approaches were employed sequentially—staged combined approach tympanoplasty (CAT), open cavity tympanoplasty and attico-antrotomy. Surgically-induced deafness occurred in 3.3 per cent. All surgical groups showed similar hearing results, except for less conductive deafness in the CAT group. Surgical management is discussed with reference to current theories of the erosive effects of cholesteatoma.

Information

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 100 , Issue 10 , October 1986 , pp. 1115 - 1123
Copyright
Copyright © JLO (1984) Limited 1986

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References

Abramson, M., Harker, L. A. and McCabe, B. F. (1974) Labyrinthine fistula complicating chronic suppurative otitis media. Archives of Otolaryngology, 100: 141–142.CrossRefGoogle Scholar
Abramson, M. and Huang, C. C. (1977) Localisation of collagenase in middle ear cholesteatoma. Laryngoscope, 87: 771–791.CrossRefGoogle ScholarPubMed
Baron, S. H. (1953) Why and when I do not remove the matrix.Symposium on the surgical management of aural cholesteatoma. Transactions of the American Academy of Ophthalmology and Otolaryngology, 57: 694.Google Scholar
Cole, J. M. and Reams, C. L. (1983) Tympanomastoidectomy—a 25-year experience. Annals of Otology, Rhinology and Laryngology, 92: 577–581.CrossRefGoogle ScholarPubMed
Gacek, R. R. (1974) The surgical management of labyrinthine fistulae in chronic otitis media with cholesteatoma. Annals of Otology, Rhinology and Laryngology, 83 Supplement 10: 3–19.Google Scholar
Gantz, B. J. (1984) Epidermal Langerhan's cells in cholesteatoma. Annals of Otology, Rhinology and Laryngology, 93: 150–156.CrossRefGoogle ScholarPubMed
Iino, Y., Hoshino, E., Tomioka, S., Takasaka, T., Kaneko, Y. and Yuasa, R. (1983). Organic acids and anaerobic micro-organisms in the contents of the cholesteatoma sac. Annals of Otology, Rhinology and Laryngology, 92: 91–96.CrossRefGoogle Scholar
Law, K. P., Smyth, G. D. L. and Kerr, A. G. (1975) Fistula of the labyrinth treated by staged combined approach tympanoplasty. Journal of Laryngology and Otology, 89: 471–478.Google Scholar
Lim, D. and Saunders, W. (1972) Acquired cholesteatoma. Annals of Otology, Rhinology and Laryngology, 81: 2–12.Google Scholar
McCabe, B. F. (1983) Labyrinthine fistula in chronic mastoiditis. Annals of Otology, Rhinology and Laryngology, 93 Supplement 112: 138–141.Google Scholar
Macri, J. R. and Chole, R. A. (1985) Bone erosion in experimental cholesteatoma-the effects of implanted barriers. Otolaryngology—Head and Neck Surgery, 93: 3–17.CrossRefGoogle ScholarPubMed
Moriyama, H., Huang, C. C., Kato, M. and Abramson, M. (1985) Effects of pressure on bone resorption in the middle ear of rats. Annals of Otology, Rhinology and Laryngology, 94: 60–64.CrossRefGoogle Scholar
Palva, T., Karja, J. and Palva, A. (1971) Opening of the labyrinth during chronic ear surgery. Archives of Otolaryngology, 93: 75–78.CrossRefGoogle ScholarPubMed
Ritter, F. N. (1970) Chronic suppurative otitis media and the pathologic labyrinthine fistula. Laryngoscope, 80: 1025–1035.CrossRefGoogle ScholarPubMed
Ruedi, L. (1978) Pathogenesis and surgical treatment of middle ear cholesteatoma. Acta Otolaryngologica (Stockholm) Supplement 361: 1–45.Google Scholar
Sadé, J. and Halevy, A. (1974) The aetiology of bone destruction in chronic otitis media. Journal of Laryngology and Otology, 88: 139–143.CrossRefGoogle ScholarPubMed
Sanna, M., Zini, C., Bacciu, R., Scandellari, R., Delogu, P. and Jemmi, G. (1984) Management of the labyrinthine fistula in cholesteatoma surgery. Otorhinolaryngology, 46: 165–172.Google ScholarPubMed
Sheehy, J. L. and Brackmann, D. E. (1979) Cholesteatoma surgery: management of the labyrinthine fistula-a report of 97 cases. Laryngoscope, 89: 78–87.Google Scholar
Smyth, G. D. L. (1980) Cholesteatomatous fistula of the labyrinth. In: Chronic otitis media. Churchill Livingstone, Edinburgh, pp. 189–195.Google Scholar
Smyth, G. D. L. (1985) Cholesteatoma surgery: the influence of the canal wall. Laryngoscope, 95: 92–96.CrossRefGoogle ScholarPubMed
Veldman, J. E., Visser, C. E., Schuurman, H. J., DeGroot, J. C. M. and Huizing, E. H. (1984). Immunobiology of Langerhan's cells migrating into aural cholesteatomas. Otolaryngology—Head and Neck Surgery, 92: 1–6.Google Scholar
Walsh, T. E. (1953) Why I remove the matrix. Symposium on the surgical managemnt of aural cholesteatoma. Transactions of the American Academy of Ophthalmology and Otolaryngology, 57: 687.Google Scholar