Surgical treatment of labyrinthine fistula in cholesteatoma surgery
Surgical treatment of labyrinthine fistula in cholesteatoma surgery
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DOI：
10.1016/j.otohns.2008.11.028
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发表时间：
2009-03-01
影响因子：
3.4
通讯作者：
Quaranta, Antonio
中科院分区：
文献类型：
--
作者：
Quaranta, Nicola;Liuzzi, Cristina;Quaranta, Antonio
目的/假设：评价一大系列中耳胆脂瘤迷路瘘的治疗。研究设计：三级转诊中心的病例系列。方法：2001年1月至2007年12月，361耳乳突和中耳胆脂瘤患者接受手术治疗。结果：迷路瘘发生率为12.7%，术中除1例外，其余均摘除瘘口外基质。在较大的胆脂瘤中发生迷路瘘的病例较多(P<；0.001)，面神经外露(P<；0.001)和距骨上结构受侵蚀(P=0.010)。结论：保留骨传导阈值是小瘘管的常见表现，在“大”瘘管中也可以保留，只要选择合适的手术方法。在累及海角的瘘管中，当累及骨膜时，基质应留在原位。
OBJECTIVE/HYPOTHESIS: Evaluate the treatment of labyrinthine fistula in a large series of middle ear cholesteatomas.STUDY DESIGN: Case series in a tertiary referral center.METHODS: Between January 2001 and December 2007, 361 ears affected by mastoid and middle ear cholesteatoma were operated at Our institution. The incidence of labyrinthine fistula, preoperative and postoperative hearing function, preoperative symptoms, type of surgery, and intraoperative findings were all analyzed.RESULTS: The incidence of labyrinthine fistula was 12.7 percent, During Surgery the matrix over the fistula was removed in all but one case. A labyrinthine fistula occurred in larger cholesteatomas as demonstrated by the higher number of cases with more than two sites involved (P < 0.001), facial nerve exposed (P < 0.001), and stapes superstructure eroded (P = 0.010). Postoperative change of bone conduction threshold and postoperative dead cars were not significantly different between fistula and nonfistula cases.CONCLUSIONS: The preservation of the bone conduction threshold is a common finding in small fistulas and can be obtained also in "large" fistulas when appropriate surgical technique is used. In fistulas involving the promontory the matrix should be left in situ when the endosteum is involved.