Labyrinthine fistula after cholesteatomatous chronic otitis media

Objectives: To report on cases of labyrinthine fistula diagnosed in an ear, nose, and throat department and to study the incidence, location, pre- and postoperative symptoms (hearing loss, tinnitus, vertigo, facial palsy), pr eoperative diagnostic imaging, and surgical treatment of two types of chole steatomatous labyrinthine fistulae-the extensive fistula that erodes both t he bony and membranous labyrinths and the bone fistula that affects only th e bony abyrinth. Study Design: Retrospective case review. Patients: Fifty-four patients with cholesteatomatous chronic otitis media w ith labyrinthine fistulae. Setting: Tertiary referral center. Interventions: Diagnosis and treatment. Main Outcome Measures: Clinical, imaging, and surgical correlation of exten sive fistulae and bone fistulae. Results: The incidence of labyrinthine Fistulae was 7% in all patients who underwent surgery for chronic otitis media. The bone type (66%) is more com mon than the extensive type (33%). Compared with bone fistulae, the outcome for extensive fistulae is more severe in terms of hearing loss, vertigo, a nd facial palsy. In terms of preoperative diagnosis, computed tomography im aging ensured early diagnosis in 89% of extensive cases and in 28% of bone cases. For extensive fistulae, the surgical technique was more radical, req uiring an open technique in 66% of cases versus 22%, of the bone fistulae c ases. The most common location is the lateral semicircular canal (61%). Conclusions: The breach in the membranous labyrinth is consistent with a mo re aggressive pathology,causing more severe pre- and postoperative symptoms . Preoperative computed tomography is more sensitive for diagnosing extensi ve fistulae, which also require a more radical treatment.