One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes

Yoon Chan Rah, Won Gue Han, Jae Woo Joo, Kuk Jin Nam, Jihye Rhee, Jae-Jun Song, Gi Jung Im, Sungwon Chae, Hak Hyun Jung, June Choi

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix. Methods: Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed. Results: Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P =.083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3%), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss (P =.027). Conclusion: Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.

Original languageEnglish
Pages (from-to)241-248
Number of pages8
JournalAnnals of Otology, Rhinology and Laryngology
Volume127
Issue number4
DOIs
Publication statusPublished - 2018 Apr 1

Fingerprint

Cholesteatoma
Hearing
Fistula
Hearing Loss
Middle Ear Cholesteatoma
Perilymph
Bone Conduction
Air

Keywords

  • cholesteatoma
  • hearing loss
  • labyrinthine fistula
  • recurrence
  • surgical resection

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes",
abstract = "Objectives: To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix. Methods: Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed. Results: Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P =.083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3{\%}), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss (P =.027). Conclusion: Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.",
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author = "Rah, {Yoon Chan} and Han, {Won Gue} and Joo, {Jae Woo} and Nam, {Kuk Jin} and Jihye Rhee and Jae-Jun Song and Im, {Gi Jung} and Sungwon Chae and Jung, {Hak Hyun} and June Choi",
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AU - Rah, Yoon Chan

AU - Han, Won Gue

AU - Joo, Jae Woo

AU - Nam, Kuk Jin

AU - Rhee, Jihye

AU - Song, Jae-Jun

AU - Im, Gi Jung

AU - Chae, Sungwon

AU - Jung, Hak Hyun

AU - Choi, June

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AB - Objectives: To evaluate long-term hearing changes and surgical outcomes for middle ear cholesteatoma with labyrinthine fistula following complete surgical removal of the cholesteatoma matrix. Methods: Consecutive samples of 43 patients who underwent 1-stage complete resection of the cholesteatoma matrix overlying a labyrinthine fistula were obtained. Immediate and long-term hearing changes were analyzed in association with fistula size. Accuracy of various diagnostic examinations was assessed. Results: Immediately postsurgery, the average bone conduction threshold (43.34 dB) did not differ significantly from the preoperative value (36.66 dB, P =.083). There were also minimal changes thereafter (45.63 dB) without recurrent case over an average follow-up time of 38.3 months (range, 17-69 months). More than 10 dB hearing loss was found in 7 patients with a case of intraoperative perilymph leakage (2.3%), although 5 of them had had preoperative air conduction threshold above 90 dB. Their fistulas were significantly larger than those of patients without hearing loss (P =.027). Conclusion: Although caution is required for total removal of a large fistula, owing to increased risk of postoperative hearing deterioration, 1-stage complete resection of cholesteatoma matrix on labyrinthine fistula could be effective in disease control and long-term hearing preservation.

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