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Endoscope-guided round window fistula repair
1Department of Otorhinolaryngology, Tampere University Hospital, P.O. Box 2000, FIN-33521, Tampere, Finland.
Objective:
Endoscope-guided round window membrane repair was performed to evaluate whether the approach is feasible in the treatment of a round window fistula.
Study Design:
Retrospective case review.
Setting:
Tertiary care academic center.
Patient:
A 27-year-old man had been scuba diving 6 days previously in the Australian Great Barrier Reefs. He had poor hearing with tinnitus in the left ear and a vertiginous sensation.
Intervention:
A myringotomy was incised, and a tympanoscope was introduced into the middle ear cavity. With the patient under general anesthesia, the middle ear and the oval and round window areas were examined with a tympanoscope. In endoscopic visualization, a round perforation could be seen in the round window membrane. After detection of the round window perforation, a small piece of temporal fascia was obtained to seal the membrane perforation.
Results:
One month after the operation, the patient's hearing was significantly better. The myringotomy had healed.
Conclusion:
A transmyringeal endoscopic procedure for round window fistula repair is feasible and combines the best features of minimally invasive surgery and aural endoscopy.
