PDF(Pubmed)
Abstract：
A labyrinthine fistula is a severe complication of middle ear cholesteatoma that can cause profound sensorineural hearing loss and vertigo. However, there is no consensus regarding the transition to postoperative hearing. Although hearing deteriorates gradually with a delay in some cases of labyrinthine fistula, insufficient consideration has been given to this point. We examined perioperative changes in cases of middle ear cholesteatoma with labyrinthine fistulas. We retrospectively reviewed the medical records of 578 patients with middle ear cholesteatoma who underwent tympanoplasty at our hospital between 2016 and 2021. Patients with labyrinthine fistulas were selected; their perioperative bone-conduction hearing was assessed. Fistula depth was determined following the classification reported by Dornhoffer et al. The hearing was compared preoperatively, early postoperatively (3-6 months), and 1 year postoperatively. Forty-eight patients (8.3%) had labyrinthine fistulas. Regarding depth, 21 cases were type I, 14 were type IIa, 3 were type IIb, and 10 were type III. Preoperative bone-conduction hearing was significantly poor in invasion type IIb or deeper cases. Cases with type IIb or deeper fistulas, multiple fistulas, or vertigo deteriorated postoperatively. Type III cases or those with multiple fistulas deteriorated further from the early postoperative period to 1 year postoperatively. Concerning frequency, 500 and 2000 Hz showed a delayed deterioration. This is a valuable report of delayed hearing loss after surgery in patients with a labyrinthine fistula. This change is associated with the labyrinthine fistula\'s depth and multiple fistulas-this is important during preoperative counseling of patients undergoing surgery.
摘要：
迷路瘘是中耳胆脂瘤的严重并发症，可引起严重的感觉神经性听力损失和眩晕。然而,对于向术后听力的过渡尚无共识.尽管在某些情况下，迷路瘘的听力会随着延迟而逐渐恶化，对这一点考虑不够。我们检查了伴有迷路瘘的中耳胆脂瘤病例的围手术期变化。我们回顾性回顾了2016年至2021年间在我们医院接受鼓室成形术的578例中耳胆脂瘤患者的病历。选择患有迷路瘘的患者；评估了他们围手术期的骨传导听力。按照Dornhoffer等人报告的分类确定瘘深度。术前比较了听力，术后早期（3-6个月），术后1年。48例患者（8.3％）患有迷宫瘘。关于深度,21例为Ⅰ型,14个是IIa型，3个是IIb型，10人是III型。在IIb型或较深的情况下，术前骨传导听力明显较差。患有IIb型或较深瘘管的病例，多个瘘管,或眩晕术后恶化。从术后早期到术后1年，III型病例或多个瘘的病例进一步恶化。关于频率，500和2000Hz显示延迟劣化。这是关于迷路瘘患者手术后延迟听力损失的有价值的报告。这种变化与迷路瘘的深度和多个瘘有关-这在手术患者的术前咨询中很重要。
