Fistula of labyrinth Including bone erosion, exposure of the endosteal membrane and a true fistula into the fluid compartment of the inner ear It occurs in 5-10% of cases with cholesteatoma Lateral semicircular canal is the most common location (90%) Mechanism of bone erosion LSC 1 Osteolysis I resorptive osteitis
Fistula of labyrinth ◼ Including bone erosion, exposure of the endosteal membrane and a true fistula into the fluid compartment of the inner ear. ◼ It occurs in 5-10% of cases with cholesteatoma ◼ Lateral semicircular canal is the most common location (90%) ◼ Mechanism of bone erosion ◼ Osteolysis ◼ resorptive osteitis
Fistula of labyrinth Diagnosis u Vertigo(intermittent or constant s Hearing loss Fistula test(only 50% of patients are positive) CT scan may demonstrate evidence SS/2n of fistula however small fistula can be overlooked
Fistula of labyrinth ◼ Diagnosis ◼ Vertigo (intermittent or constant) ◼ Hearing loss ◼ Fistula test (only 50% of patients are positive) ◼ CT scan may demonstrate evidence of fistula, however, small fistula can be overlooked
Fistula of labyrinth Managements Surgical invervention mastoidectomy Removal cholesteatoma matrix at the primary operation, fistula closed with temporal fascia Leaving cholesteatoma matrix undisturbed. 9-12 months later second operation is performed antibiotic
Fistula of labyrinth ◼ Managements ◼ Surgical invervention ◼ mastoidectomy ◼ Removal cholesteatoma matrix at the primary operation, fistula closed with temporal fascia ◼ Leaving cholesteatoma matrix undisturbed. 9-12 months later, second operation is performed. ◼ antibiotic