NATIONAL MILITARY MEDICAL CLINICAL CENTER "MAIN MILITARY CLINICAL HOSPITAL", KYIV, UKRAINE.
SI "INSTITUTE OF OTOLARYNGOLOGY NAMED AFTER PROF. O.S. KOLOMIYCHENKO NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE " KYIV, UKRAINE.
Wiad Lek. 2023;76(5 pt 2):1246-1251. doi: 10.36740/WLek202305217.
The aim: To evaluate the effectiveness of treatment patients with spontaneous PLF and labyrinthine window ruptures by studying the clinical and audiological results.
Materials and methods: 52 patients after exposure to traumatic factors in the anamnesis were evaluated. The perilymphatic fistula was diagnosed in 18 patients after the complex examination. All patients with PLF underwent surgical treatment.
Results: Vestibular disorders and hearing loss were the predominant symptoms. The fistula test was positive in 11 (61%) patients. Fluctuating hearing loss was determined in 9 (50%) patients. Labyrinthine window ruptures were detected in 16 (88%) patients: oval window membrane rupture was identified in 6 patients, and in another 10 patients round window membrane rupture was found and was detected on CT scan. The surgical treatment included minimally invasive tympanotomy with combined microscopic and endoscopic visualization and sealing techniques. Results were evaluated in 6 months after surgical treatment, patients had a decrease in bone and air conduction thresholds at all evaluated frequencies and a significant decrease in the level of the air-bone interval.
Conclusions: Fluctuating hearing loss is considered one of the key symptoms, which suggests the presence of PLF. Determination of PLF and its surgical treatment, by using minimally invasive tympanotomy with sealing technique using optimal combined visualization, allows obtaining a stable functional result, with hearing improvement and vestibular symptoms reducing.
通过研究临床和听力学结果,评估治疗自发性 PLF 和迷路窗破裂患者的效果。
材料和方法:对 52 例有创伤因素病史的患者进行评估。在综合检查后,18 例患者被诊断为迷路瘘管。所有 PLF 患者均接受手术治疗。
结果:前庭障碍和听力损失是主要症状。11 例(61%)患者瘘管试验阳性。9 例(50%)患者存在波动性听力损失。16 例(88%)患者发现迷路窗破裂:6 例患者为卵圆窗膜破裂,另 10 例患者为圆窗膜破裂,并在 CT 扫描中发现。手术治疗包括微创鼓室切开术,并结合显微镜和内镜可视化及密封技术。在手术后 6 个月评估结果,所有评估频率的骨导和气导阈值均降低,气骨导间隔水平显著降低。
结论:波动性听力损失被认为是提示存在 PLF 的关键症状之一。通过使用微创鼓室切开术和使用最佳联合可视化的密封技术来确定 PLF 并进行治疗,可以获得稳定的功能结果,听力改善,前庭症状减轻。