scholarly journals Management of labyrinthine fistula using Surdille flap

2017 ◽  
Vol 4 (1) ◽  
pp. 32
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Canal Wall ◽  
Endochondral Bone ◽  
Labyrinthine Fistula ◽  
Modified Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Vestibular Symptoms ◽  
Postoperative Vertigo

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.</span></p>

scholarly journals Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

2016 ◽  
Vol 21 (03) ◽  
pp. 239-242 ◽  
Author(s):  
Suphi Bulğurcu ◽  
İlker Arslan ◽  
Bünyamin Dikilitaş ◽  
İbrahim Çukurova
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Ossicular Chain ◽  
Facial Canal ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant (p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

Surgical Treatment of Labyrinthine Fistula Caused by Cholesteatoma

2000 ◽  
Vol 122 (5) ◽  
pp. 739-742 ◽  
Author(s):  
Antonio Soda-Merhy ◽  
Miguel Angel Betancourt-Suárez
Keyword(s):  
Chronic Otitis Media ◽  
Safe Procedure ◽  
Canal Wall ◽  
Cochlear Function ◽  
Horizontal Semicircular Canal ◽  
Labyrinthine Fistula ◽  
The Matrix ◽  
Preoperative Ct ◽  
Canal Wall Down

In a 144-month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal-wall-down procedure was performed in 92%, and the canal-wall-up procedure was performed in 8%. In 88% of patients the fistula was located in the horizontal semicircular canal. In 96% of patients the cholesteatoma matrix was removed, and the fistula was sealed; in 4% of patients the matrix was left. With a follow-up of 13 years, vertigo disappeared in 96% of patients, and hearing remained unchanged in 70% of patients. Further complications of chronic otitis media existed in approximately half of the patients with LF. Open surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia in a canal-wall-down manner is a safe procedure that can make vertigo disappear and helps to preserve cochlear function.

Revision Surgery for Chronic Otitis Media: A Learning Experience

1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Learning Experience ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Long Term Follow Up ◽  
Surgical History ◽  
History Of ◽  
Canal Wall Down ◽  
Residual Air

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.

Long-term outcome of ossiculoplasty using autogenous mastoid cortical bone

2014 ◽  
Vol 128 (10) ◽  
pp. 866-870 ◽  
Author(s):  
Z Yu ◽  
L Zhang ◽  
D Han
Keyword(s):  
Cortical Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Prosthetic Material ◽  
Canal Wall ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Wall Down ◽  
Canal Wall Up

AbstractObjective:To observe the long-term outcome of ossiculoplasty using autogenous mastoid cortical bone in chronic otitis media in-patients.Methods:Sixty-one ears of 57 in-patients with chronic otitis media, with or without cholesteatoma, underwent type III tympanoplasty using autogenous mastoid cortical bone as the prosthetic material. Twenty-one ears were treated by canal wall down mastoidectomy and 40 ears by canal wall up mastoidectomy. The follow-up period was 3 to 6 years (average 4.2 years). Pure tone averages for thresholds at 0.5, 1, 2 and 3 kHz were calculated using standard conventional audiometry.Results:The pre-operative mean air–bone gap of 31.6 dB, for all ears, was reduced to 20.3 dB post-operatively. For the 40 canal wall up ears, this value decreased from 30.8 dB to 19.9 dB, and for the 21 canal wall down ears it decreased from 33.0 dB to 21.0 dB. The differences between the pre- and post-operative mean air–bone gap values were significant.Conclusion:No cases of extrusion, necrosis or resorption were exhibited for the autogenous mastoid cortical bone prosthesis. A significant hearing improvement was obtained in the majority of cases and this remained stable over time.

scholarly journals Surgical Outcomes of Revision Operation for Non-Cholesteatomatous Chronic Otitis Media

2021 ◽  
Vol 64 (5) ◽  
pp. 304-309
Author(s):  
Juho Han ◽  
Jisoo Lee ◽  
Sung Kwang Hong ◽  
Hyo Jeong Lee ◽  
Hyung-Jong Kim
Keyword(s):  
Otitis Media ◽  
Surgical Outcomes ◽  
Chronic Otitis Media ◽  
Surgical Approaches ◽  
Middle Ear Surgery ◽  
Canal Wall ◽  
Revision Operation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Better Than

Background and Objectives The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups.Results Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (<i>p</i>=0.023), and CMUM (<i>p</i>=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (<i>p</i>=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (<i>p</i>=0.001), and CMUM (<i>p</i>=0.011). And, that of CMUM was better than that of CMDM (<i>p</i>=0.011).Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.

Revision surgery for chronic otitis media: recurrent-residual disease and hearing

2002 ◽  
Vol 116 (12) ◽  
pp. 996-1000 ◽  
Author(s):  
Stephen O’Leary ◽  
Jan E. Veldman
Keyword(s):  
Retrospective Analysis ◽  
Otitis Media ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Residual Disease ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Persistent Disease ◽  
Canal Wall Down

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronicotitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present. Hearing was reconstructed with allograft incus. Follow-up ranged from one to 15 years. Hearing was determined by pre- and post-operative air-bone gaps.Post-operative re-perforation, aural discharge and/or cholesteatoma rates were similar for CWD and ICW. Cholesteatoma could present following the revision, even though it was not apparentat surgery. Following tympanoplasty, the final hearing was not significantly affected by the surgical approach or presence of cholesteatoma. Improvement in hearing was adversely affected by cholesteatoma or an absent stapes suprastructure.Revision ICW and CWD operations were both successful in controlling signs of COM. Cholesteatoma is a peripheral risk in COM and may become apparent after revision surgery.

scholarly journals TO EVALUATE THE HEARING RESULTS FOLLOWING OSSICULAR RECONSTRUCTION IN PATIENT WITH CHRONIC SUPPURATIVE OTTITIS MEDIA.

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Arjun Nath Yogee ◽  
Navneet Mathur
Keyword(s):  
Otitis Media ◽  
Chronic Infection ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Hearing Results ◽  
Ossicular Reconstruction ◽  
Ear Ossicles ◽  
Life Threatening ◽  
Canal Wall Down ◽  
A Prospective Study

Background: Chronic otitis media erodes the bone, destroys the ossicles and has the potential to cause life threatening complications. Methods: This is a prospective study involving patients with chronic otitis media. 120 patients were included and all of them are subjected to ossicular reconstruction either by canal wall down or intact canal wall surgery. Results: As per Wehr's classification 80% of patients in Group 1A have got improvement and 20% have failed to gat improved in A-B gap, in Group 1B 20% -have failed to get improved in A-B gap and in Group 1C, 30% have failed to get improved in A-B gap. 70% of patients in Group 2A have got improvement and 30% have failed to gat improved in A-B gap, in Group 2B 80% of patients have got improvement and 20% -have failed to get improved in A-B gap and in Group 2C 70% of patients have got improvement and 30% have failed to get improved in A-B gap. Conclusion: All the three modalities gave statistically significant improvement (p < 0.001) in A-B gap leading to improvement in hearing but among the three groups there was no statistically significant (p > 0.05) difference found in improvement of A-B gap. Keywords: Chronic Infection, Middle Ear, Ossicles.

scholarly journals Extradimension of fasciocutaneous flap in the surgical management of postaural fistula, a complication of chronic otitis media – squamous type

2017 ◽  
Vol 3 (2) ◽  
pp. 419
Author(s):  
Madhubari Vathulya ◽  
Manu Malhotra ◽  
Saurabh Varshney
Keyword(s):  
Otitis Media ◽  
Surgical Techniques ◽  
Chronic Otitis Media ◽  
Neck Region ◽  
Fasciocutaneous Flap ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tertiary Referral ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

<p>Post aural fistula is one of the complications of squamous variety of chronic otitis media (COM-S). For decades together a lot of new surgical techniques have been introduced in the treatment of COM-S out of which canal wall down mastoidectomy is most commonly practised. Despite these efforts many patients presenting with COM-S end up in tertiary referral centers at a late stage with complications like fistulas and by this time a number of procedures have already been done on them. A 19 year old female presents with Postaural fistula as a complication of COM- S type. Due to the local scarring, newer flap options needed to be sought to obliterate the mastoid cavity. This article demonstrates the extra dimension for the usage of fasciocutaneous flap from neck region to treat patients of recurrent postaural fistula.</p>

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