[Surgical treatment of inflammatory labyrinthine fistulae 23 cases]

To report the experience of surgical treatment of inflammatory labyrinthine fistula (LF).

Twenty-three patients with cholesteatomatous otitis media complicated with LF underwent mastoidectomy, surgical repair and obliteration of LF. After removal of cholesteatoma matrix and inflammatory lesion around fistula, the fistulae were treated as following procedures: fistulae less than 2 mm in diameter were overlaid with fascia (7 cases), those 2 to 3 mm were obliterated with bone chips and fascia (13 cases), and for those more than 3 mm, the bony semicircular canal lumen were packed with fascia and bone chips, then overlaid with fascia.

In 23 patients with LF, which included 22 lateral semicircular canal fistulae (SCF) and one lateral combined with posterior SCF, two patients lost follow-up and 21 cases were observed with an average follow-up period of 2.5 years. In this series of cases, vertigo disappeared in 17 and diminished in 2. With the exception of total deafness in two cases, the average auditory thresholds in speech frequencies remained unchanged, showing that the thresholds of air conduction (AC) and bone conduction (BC) were 67.1 dB HL and 37.1 dB HL prior operation versus 69.1 dB HL and 30.6 dB HL after operation, respectively.

Because of structural barrier between superior and inferior labyrinth and inflammatory adhesions, surgical treatment of inflammatory LF is feasible and effective. Successful operation depends on excellent microsurgery skill, complete removal of inflammatory lesion, precise obliteration of fistula, post-operative administration of antibiotics and steroids and close follow-up. In addition to fistula test, axial petrous bone CT scan is a good complemental method in preoperative diagnosis of LF.