Labyrinthine Fistula in Chronic Otitis Media with Cholesteatoma

Objective: To present the experience in the operative management of labyrinthine fistula caused by cholesteatoma. Methods: The clinical charts of 16 patients who underwent surgical procedures for cholesteatoma complicated by labyrinthine fistula between 2003 and 2008 were reviewed retrospectively. In this period, 108 ears were operated for cholesteatoma. In each patient, the site and size of the fistula were evaluated during surgery and the hearing thresholds were compared before and after surgery. Results: The fistula involved the lateral semicircular canals in 15 patients. Multiple fistulae were observed in one patient. Postoperative hearing levels were unchanged or improved in 88% patients. Favourable outcomes were obtained in patients treated with surgical sealing of the interrupted labyrinth. Conclusion: The current study confirmed that careful manipulation of the labyrinthine fistula is mandatory to preserve hearing function in these patients. According to the author's experience, the canal wall down transmastoid approach with mastoid cavity obliteration is a favourite technique of labyrinthine fistula treatment.