Labyrinthine fistula after cholesteatomatous chronic otitis media
Labyrinthine fistula after cholesteatomatous chronic otitis media
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DOI：
10.1016/s0196-0709(00)80072-1
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发表时间：
2000-01-01
期刊：
影响因子：
--
通讯作者：
Bosch, P
中科院分区：
文献类型：
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作者：
Gersdorff, MCH;Nouwen, J;Bosch, P
目的：报告在耳鼻咽喉科诊断为迷路瘘的病例，并研究两种类型的胆脂瘤性迷路瘘的发生率、位置、前后症状(听力损失、耳鸣、眩晕、面瘫)、术前影像诊断和手术治疗。主要指标：临床、影像、骨瘘和仅累及骨迷路的骨瘘。研究设计：回顾性病例回顾。患者：54例合并迷路的胆脂瘤性慢性中耳炎。背景：第三转诊企业：诊断和治疗。结果：所有接受手术治疗的慢性中耳炎患者中，迷路瘘的发生率为7%。骨型(66%)比广泛型(33%)更常见。与骨瘘相比，广泛瘘管的结果在听力损失、眩晕和面瘫方面更为严重。在术前诊断方面，CT成像确保了89%的广泛性病例和28%的骨骼病例的早期诊断。对于广泛的瘘管，外科技术更为激进，66%的病例需要开放技术，而骨瘘病例中需要22%的病例。最常见的部位是外侧半规管(61%)。结论：膜迷路破裂符合更具侵袭性的病理，导致更严重的术前和术后症状。术前计算机断层扫描对诊断广泛的瘘管更敏感，这也需要更彻底的治疗。
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), preoperative diagnostic imaging, and surgical treatment of two types of cholesteatomatous labyrinthine fistulae-the extensive fistula that erodes both the bony and membranous labyrinths and the bone fistula that affects only the bony abyrinth.Study Design: Retrospective case review.Patients: Fifty-four patients with cholesteatomatous chronic otitis media with labyrinthine fistulae.Setting: Tertiary referral center.Interventions: Diagnosis and treatment.Main Outcome Measures: Clinical, imaging, and surgical correlation of extensive 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 common than the extensive type (33%). Compared with bone fistulae, the outcome for extensive fistulae is more severe in terms of hearing loss, vertigo, and facial palsy. In terms of preoperative diagnosis, computed tomography imaging ensured early diagnosis in 89% of extensive cases and in 28% of bone cases. For extensive fistulae, the surgical technique was more radical, requiring an open technique in 66% of cases versus 22%, of the bone fistulae cases. The most common location is the lateral semicircular canal (61%).Conclusions: The breach in the membranous labyrinth is consistent with a more aggressive pathology,causing more severe pre- and postoperative symptoms. Preoperative computed tomography is more sensitive for diagnosing extensive fistulae, which also require a more radical treatment.