Postoperatively, three expert head and neck radiologists who were blinded to patients' clinical and surgical data re-evaluated these temporal MDCT images with respect to ossicular and scutum erosion, tegmen tympani defect, labyrinthine fistula
, posterior wall remodeling or erosion, opening of the eustachian tube, and sinus tympani.
is formed by the erosion of the bony labyrinth.
Mair, "Labyrinthine fistula
detection: the predictive value of vestibular symptoms and computerized tomography," Acta Oto-Laryngologica, vol.
Can CT detect labyrinthine fistula
Palva and fellows concluded in their study that the labyrinthine fistula
may occur in 10% of patients with chronic ear infection due to cholesteatoma23.
HRCT clearly depicts bone erosion even in the absence of fistula which helps surgeon intra-operatively in careful resection of cholesteatoma to prevent labyrinthine fistula
(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.
In this study, the prevalence of the labyrinthine fistula
was 16.2% and all patients were managed by the sandwich method (fascia, bone dust, fascia).
The invasive expansion and the keratin accumulation may cause bony destruction, hearing impairment, facial nerve paralysis, labyrinthine fistula
, as well as intracranial complications such as brain abscess and meningitis.
(13,15) Finally, using a different imaging protocol, a human temporal bone study showed how virtual endoscopy was even able to detect a very small (<0.5 mm) labyrinthine fistula
These include damage to oval or round windows during removal of cholesteatoma or granulations from these areas, excessive manipulation of ossicles resulting in their dislocation or fracture, acoustic trauma from drill generated noise or from suction, inadvertent opening of lateral semicircular canal while remov-ing cholesteatoma matrix resulting in labyrinthine fistula
.1 The damage to hearing during surgery has disastrous consequences for both the patient and the surgeon.