Abstract
Objectives: To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix. Methods: Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed. Results: Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P =.083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3%), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss (P =.027). Conclusion: Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.
Original language | English |
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Pages (from-to) | 241-248 |
Number of pages | 8 |
Journal | Annals of Otology, Rhinology and Laryngology |
Volume | 127 |
Issue number | 4 |
DOIs | |
Publication status | Published - 2018 Apr 1 |
Bibliographical note
Funding Information:The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant No. 2017R1D1A1B03036131).
Publisher Copyright:
© 2018, © The Author(s) 2018.
Keywords
- cholesteatoma
- hearing loss
- labyrinthine fistula
- recurrence
- surgical resection
ASJC Scopus subject areas
- Otorhinolaryngology