One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes
- Authors
- Rah, Yoon Chan; Han, Won Gue; Joo, Jae Woo; Nam, Kuk Jin; Rhee, Jihye; Song, Jae Jun; Im, Gi Jung; Chae, Sung Won; Jung, Hak Hyun; Choi, June
- Issue Date
- 4월-2018
- Publisher
- SAGE PUBLICATIONS INC
- Keywords
- labyrinthine fistula; cholesteatoma; hearing loss; recurrence; surgical resection
- Citation
- ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, v.127, no.4, pp.241 - 248
- Indexed
- SCIE
SCOPUS
- Journal Title
- ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY
- Volume
- 127
- Number
- 4
- Start Page
- 241
- End Page
- 248
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/76662
- DOI
- 10.1177/0003489418755407
- ISSN
- 0003-4894
- Abstract
- Objectives: To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix. Methods: Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed. Results: Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P = .083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3%), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss (P = .027). Conclusion: Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.
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