Sagar Prem, Devaraja K, Kumar Rajeev, Bolu Sumanth, Sharma Suresh C
Department of Otorhinolaryngology and Head Neck Surgery, AIIMS, ENT Office- 4057, 4thfloor, Teaching Block, New Delhi, 110029 India.
Indian J Otolaryngol Head Neck Surg. 2017 Jun;69(2):204-209. doi: 10.1007/s12070-017-1072-y. Epub 2017 Jan 19.
Issues of complete disease clearance and hearing preservation in cholesteatoma induced labyrinthine fistula cases has been discussed and updated in this article. Successful disease clearance and hearing preservation in a case of cholesteatoma induced isolated cochlear promontory fistula encouraged us to retrospectively analyse 13 more cases of cholesteatoma induced labyrinthine fistula who presented in emergency service as complicated chronic suppurtive otitis media. Pre-operatively nine patients experienced vertigo, two had profound sensori neural hearing loss and radiology was suggestive of labyrinthine fistula in 12 patients. Lateral semicircular canal was involved in 13 cases. In all cases cholesteatoma matrix was completely removed from the fistula site irrespective of the fistula size and hearing status. Hearing was preserved in 11 out of 12 patients. Gentle and meticulous removal of the matrix and careful repair of labyrinthine fistula delivers significant hearing preservation rate along with a safe and dry ear which avoids a second look surgery.
本文讨论并更新了胆脂瘤性迷路瘘管病例中的疾病完全清除和听力保留问题。一例胆脂瘤性孤立性蜗窗瘘管成功实现疾病清除和听力保留，这促使我们对另外13例以复杂性慢性化脓性中耳炎形式出现在急诊室的胆脂瘤性迷路瘘管病例进行回顾性分析。术前，9例患者出现眩晕，2例有极重度感音神经性听力损失，12例患者的影像学检查提示存在迷路瘘管。13例患者的外侧半规管受累。在所有病例中，无论瘘管大小和听力状况如何，均从瘘管部位完全清除胆脂瘤基质。12例患者中有11例听力得以保留。轻柔细致地清除基质并小心修复迷路瘘管，可实现较高的听力保留率，并获得安全干燥的耳朵，避免二次手术。
