Analysis of Vertigo in Labyrinthine Fistula Secondary to Cholesteatoma

Han, Gyu Cheol; Woo, Joo Hyun

Abstract

BACKGROUND AND OBJECTIVES: Labyrinthine fistula is one of the common complication of the chronic otitis media with cholesteatoma. Disruption of the labyrinthine bone can lead to hearing loss and/or vestibular disturbance. This study aimed to evaluate postoperative vertigo result in patient with labyrinthine fistula and efficacy of vestibular function test for diagnosis. MATERIALS AND METHOD: A retrospective study of the clinical records of 13 patients who were operated for chronic otitis media with cholesteatoma, suspected to have secondary labyrinthine fistula, from January 2001 through June 2003 in Gachon medical school Gil hospital. All patients were evaluated by Fistular test, Vestibular function test, high resolution Temporal bone CT, Pure tone audiometry preoperatively. Vertigo was assessed by Disability Scale.
RESULTS
Canal wall down mastoidectomy were applied in all ears. Labyrinthine fistulas were confirmed in 8 patients during operation. Fistular group had higher rate of peripheral vestibular injury than no-fistular group's in vestibulo-ocular reflex. Fistula cases have high average score (2.9) than non-fistula's (1.6) in Vertigo scale preoperatively. In post-operation, the average score was 0.25 in fistular cases and 0.4 in non-fistula cases. 2 cases presented positive fistular test result (25.0%)
CONCLUSION
Although Vertigo was more severe in patients who had fistula, in post-operation, symptoms could be relieved a lot. Vestibular function test had efficacy for diagnosis of labyrinthine fistula in preoperative.