1) Surgical treatment is recommended to prevent complications of further tympanic/mastoid bone erosion, such as facial nerve injury, ossicular erosion, and labyrinthine fistula
They discuss anatomical issues that arise, such as labyrinthine fistula
and facial nerve dehiscence; controversies in management like the canal wall up versus down debate, facial nerve monitoring, endoscopes, and the value and timing of second-stage surgery; congenital cholesteatoma; recidivism; and complications of otitis media and cholesteatoma surgery.
Two fistulae were discovered, one in the horizontal semicircular canal and one in the superior semicircular canal, and both were filled with granulation tissue (as a result, labyrinthine fistula
was added to the list of complications).
As acquired cholesteatomas enlarge, complications can occur, including ossicular erosion, facial nerve canal invasion, tegmen disruption, sinus plate disruption, super-infection, and the development of labyrinthine fistula
Silent otitis media generally occurs with complications or sequelae, including meningitis (the most common complication), vague ear pain and headache, a feeling of fullness, conductive or sensorineural hearing loss, anxiety, acute attacks of otitis media, labyrinthine fistula
, endolymphatic hydrops, etc.
A labyrinthine fistula
in which cholesteatoma is unresectable does not reflexively imply that a radical procedure is needed.
Other CT findings include: erosions of scuta, destruction and displacement of the ossicular chain, labyrinthine fistulas
, facial canal erosions, tegmen tympani dehiscence, and destruction of the mastoid.
Detection of labyrinthine fistulas
in human temporal bone by virtual endoscopy and density threshold variation on computed tomographic scan.