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Summary
This study presents a case of perilymphatic fistula in a stapedectomized patient, successfully treated by closing the fistula with a tissue graft while retaining the existing prosthesis. This approach offers an alternative to complete prosthesis replacement for certain fistula cases.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Innovation
Background:
- Perilymphatic fistulae are a known complication of stapedectomy surgery.
- Traditionally, treatment involves replacing the prosthesis and graft.
- Sudden hearing loss after barotrauma can indicate fistula formation.
Observation:
- A patient with a 15-year-old polyethylene Shea strut prosthesis developed a suspected perilymphatic fistula after barotrauma.
- Exploratory tympanotomy revealed the fistula on the long side of the oval window graft.
- The prosthesis demonstrated solid lateral and medial fixation.
Findings:
- The decision was made to retain the existing polyethylene prosthesis due to its secure fixation.
- The perilymphatic fistula was successfully closed using a subcutaneous tissue graft.
- This preserved the established air-bone gap closure.
Implications:
- This case suggests that preserving a well-fixed prosthesis is a viable option for treating perilymphatic fistulae.
- It offers a less invasive alternative to complete prosthesis revision in select cases.
- Further research may explore the long-term outcomes of this conservative approach.