Abstract
Background: Underwater endoscopic repair of labyrinthine fistulae has the potential to improve visualisation and reduce the exposure of the membranous labyrinthine to air when removing disease. This work sought to undertake a safety and efficacy analysis of a novel method of underwater endoscopic ear surgery (UWEES), which can be used to repair cholesteatomatous labyrinthine fistulae. Methods: A retrospective review was conducted of 11 patients with high grade (Dornhoffer IIa or greater) labyrinthine fistula secondary to cholesteatoma operated on between 2015-2022. All patients had UWEES technique, resurfacing repair of fistulae using combinations of temporalis fascia, bone pate and/or composite cartilage. The primary outcome was pre- and post-operative bone conduction audiograms conducted at a mean of 18 months postoperatively [standard deviation (SD) 22] and secondary outcomes included subjective vertigo and recidivistic disease. Results: There was no significant difference in mean bone conduction thresholds pre- and post-operatively (Z=-0.664, P=0.51). Ten out of the eleven patients had a type II fistula (5 type IIa, 5 type IIb) and one had type III. There was no significant difference in mean hearing outcome between Dornhoffer type 2a and 2b fistulas. The patient with type 3 fistula had significant deterioration in hearing post-operatively. Only 1 patient (out of 9 patients with preoperative vertigo) had residual vertigo after 6 months. One patient (9%) had recurrent disease and one patient (9%) had residual disease at a mean follow up time of 34 months (SD 22). Conclusion: UWEES may be an effective method to preserve hearing. Longer follow up is required to assess recidivistic outcomes and full safety of the technique.
Original language | English |
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Article number | 40 |
Pages (from-to) | 1-9 |
Number of pages | 9 |
Journal | Australian Journal of Otolaryngology |
Volume | 7 |
DOIs | |
Publication status | Published - 30 Nov 2024 |
Bibliographical note
Copyright AME Publishing Company, Australian Society of Otolaryngology Head & Neck Surgery. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Keywords
- cholesteatoma
- ear, middle/surgery
- Endoscopy
- labyrinthine fistula
- treatment outcome