Clinical Analysis Of 51 Cases Labyrinthine Fistula Caused By Choleseatoma Otitis Media

Objective: To study the clinical features,diagnosis,treatment and surgical management of labyrinthine fistula cause by middle ear cholesteatoma.Methods: A restropective analysis of 51 cases with labyrinthine fistula in our hospital from April 2010 to December 2016 was conducted.Including : gender,age,the main symptoms and signs,auditory function,CT image,operative findings,surgical treatment of different labyrinthine fistula,and statistically analysed.Results: Of the 51 patients,29(56.9%)were men,and 22(43.1%)were women.The age range was from 4 to 72 years,with an average of 42.06 years.The preoperative symptoms of hearing loss was present in 50(98.0%)patients,otorhea in 47(90.0%)patients,vertigo in 23(45.0%)patients,labyrinthine fistula was found in 15(29.4%)cases by preoperative CT scan of the temporal bone.The canal wall down technique was used in all patients and the cholesteatoma matrix was completely removed in all patients and the underlying fistula repaired primarily.According to operative findings all cases had varies degrees of destruction of ossicular chain,the facial nerve canal destruction in 26(51.0%)patients,the tegmen tympani bone destruction in 11(21.6%)patients.46(90.2%)cases which we diagnosed as labyrinthine fistula located at the lateral semicircular canal,2(2.0%)cases located at the lateral and superior semicircular canals,1(2.0%)case located at superior semicircular canals,1(2.0%)case located at three semicircular canals.According to Dornhoffer classification standard,44(86.3%)cases were diagnosed as typeⅠfistula,3(5.9%)cases were diagnosed as type Ⅱfisula and4(7.8%)cases as type Ⅲ fistula,temporalis fascia or cartilage were used to seal typesⅠandⅡsemicircular canal fistula.The semicircular canal was obliterated for type of Ⅲ fistula.There was no correlation of the BC level after operation(P>0.05).Conclusions: Preoperative clinical features,auditory function and CT scan cannot sensitive to accurately diagnose of labyrinthine fistula.The verification of a labyrinthine fistula can be definitively established only at time of surgery.Completely remove the cholesteatoma matrix can be treatment of choice in these cases.The most frequent location for labyrinthine fistulas was the lateral semicircular canal.TypeⅠfistula is the most type in the labyrinthine fistula.There is no significant change in the bone-conduction hearing thresholds for patients with cholesteatomatous labyrinthine fistula after the surgery.