LABYRINTHINE FISTULA AS A COMPLICATION OF CHOLESTEATOMA

Hypothesis: The objective of this study was to present the authors' ex perience in the management of labyrinthine fistula caused by cholestea toma. Methods: The clinical charts of 92 patients who underwent surgic al procedures for cholesteatoma complicated by labyrinthine fistula be tween 1979 and 1995 were reviewed retrospectively. In this period, 1,2 05 patients were operated on for cholesteatoma. In each patient, the s ite and size of the fistula were evaluated during surgery and the hear ing thresholds were compared before and after surgery. Results: The fi stula involved the lateral semicircular canal in 71 patients. Multiple fistulas were observed in nine patients. Postoperative hearing levels were unchanged or improved in 83.7% of patients. Comparison between h earing outcomes and size of the fistula showed better findings when sm aller size fistulas were found. No significant differences between ope n and closed techniques were detected. Favorable outcomes were obtaine d in patients treated with surgical obliteration of the interrupted la byrinth. Conclusions: The current study confirmed that careful manipul ation of the labyrinthine fistula is mandatory to preserve hearing fun ctions for these patients. According to the authors' experience, the f uture trend for fistula treatment could be directed toward less conser vative techniques compared with the previous indications favoring meth ods of interruption and subsequent obliteration of the semicircular ca nals.