Cases reported "Labyrinth Diseases"

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11/73. Management of labyrinthine fistulae in chronic ear surgery.

    The appropriate management of labyrinthine fistulae has been debated in the literature for years. After several recent cases of labyrinthine fistulae at our institution, a review of the published data regarding hearing outcome with fistula management was undertaken. Results of this critical review were presented at departmental grand rounds. The grand rounds presentation, data and discussion are presented to better illuminate the topic of labyrinthine fistula management.
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ranking = 1
keywords = fistula
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12/73. Traumatic perilymphatic fistula.

    We present the case of a patient with a traumatic perilymphatic fistula and discuss the most reliable diagnostic sign in detecting this challenging disorder.
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ranking = 0.625
keywords = fistula
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13/73. Hearing preservation in perilymphatic fistula due to a congenital fistula in an adult.

    Congenital fistula in the stapedial footplate usually can be diagnosed by the recurrence of meningitis caused by spontaneous cerebrospinal fluid (CSF) in infants or young children. We report the case of a 65-year-old woman, who was initially diagnosed as having an acquired perilymphatic fistula caused by aural barotrauma and demonstrated episodic vertigo and fluctuant sensorineural hearing loss in the right ear after air travel. Surgical exploration showed a congenital circular defect in the peripheral part of the stapedial footplate with leakage of CSF. The fistula was closed by inserting a tiny piece of fascia attached to both the tympanic and perilymphatic side of the stapedial footplate utilizing the back-pressure of perilymphatic fluid and fibrin glue; hearing was preserved.
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ranking = 1.375
keywords = fistula
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14/73. Inner ear extension of vestibular schwannomas.

    OBJECTIVE: Inner ear extension of vestibular schwannomas (VSs) is a rare finding but has important clinical implications. This report reviews the treatment options and presents the experience of the Gruppo Otologico, Piacenza, italy, in this field. STUDY DESIGN: Case report and literature review. methods: Five cases of VSs with inner ear extension were surgically removed. In all of them, the cochlea was partially or completely invaded by the lesion. RESULTS: In 4 cases, the inner ear extension was preoperatively identified on magnetic resonance imaging, and the surgical removal was planned through a transotic approach. In the last case, the cochlear invasion was not detected preoperatively, and the lesion was removed during a second surgery performed to seal a cerebrospinal fluid fistula. CONCLUSIONS: VSs with inner ear extension should be distinguished from pure intralabyrinthine schwannomas because of differences in clinical significance. Cochlear involvement is more frequent than vestibular involvement and is often accompanied by a dead ear. Dead ear caused by small VSs should alert the surgeon to the possibility of a cochlear extension. The presence of an intracochlear involvement requires the adoption of an approach that allows control of the cochlear turns, and we found the transotic approach to be the most suitable. Undetected cochlear extensions that are left in place may grow with time.
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ranking = 0.125
keywords = fistula
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15/73. Traumatic perilymphatic fistula: how long can symptoms persist? A follow-up report.

    In the past 18 years 68 ears (average 3.8 per year) were explored for perilymphatic fistula (PLF). A total of nine (13%) ears had a fistula identified at operation. patients with a previous history of otologic surgery were excluded from this review. The most common etiology for PLF was head trauma (4 of 9). Most patients had persistent symptoms lasting months (average 6.7). Eighty-three percent of all patients had sudden or fluctuating hearing loss, 77 percent had vertigo or dysequilibrium, and 61 percent had tinnitus. vertigo was the most commonly improved symptom postoperatively, and only 25 percent of patients had improved hearing. There were no major complications. The authors discuss indications for operation, criteria for diagnosis of PLF, and audiometric and electronystagmographic findings. This report agrees with other recent data indicating that exploration for fistula is an uncommon procedure performed by otologists.
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ranking = 0.875
keywords = fistula
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16/73. Pneumolabyrinth associated with perilymph fistula.

    Pneumolabyrinth associated with perilymph fistula, especially with the presence of air in the cochlea, has rarely been identified using imaging study. We present a 24-year-old woman who experienced right fluctuating sensorineural hearing impairment and dis-equilibrium after sustaining an open-handed slap on the right side of her face. The diagnosis of pneumolabyrinth was established through the detection of air bubbles in the right basal turn of cochlea using high-resolution computerized tomography. Right side exploratory tympanotomy confirmed the presence of a perilymph fistula. The patient was free of symptoms after surgery. Early fistula repair was beneficial in this case.
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ranking = 0.875
keywords = fistula
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17/73. Vertical oscillopsia in bilateral superior canal dehiscence syndrome.

    A patient sought treatment for vertical oscillopsia and impaired vision during locomotion, and unsteadiness of gait. Positive fistula tests and CT of the temporal bones confirmed a diagnosis of bilateral superior canal dehiscence. An impairment of the superior canal vestibulo-ocular reflex, documented by three-dimensional search coil eye movement recordings for oblique (single) and downward pitch head motion (bilateral canal testing), is proposed to induce vertical rather than torsional-vertical oscillopsia during locomotion.
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ranking = 0.125
keywords = fistula
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18/73. Delayed labyrinthine fistula in canal wall down mastoidectomy.

    PURPOSE OF THE STUDY: This article is a retrospective review of 5 cases of delayed labyrinthine fistula in patients with a longstanding canal wall down mastoidectomy. MATERIAL: All patients had a long-term postoperative follow up with no evidence of complications till they suddenly started to have vertigo. The symptoms were caused by a bony erosion of the lateral semicircular canal detected on physical examination or by a CT-scan. There was no evidence of a recurrent cholesteatoma. RESULTS: The patients underwent surgery in order to close the fistula, with a good result. In all cases, a factor such as an infection or trauma, seems to have triggered off the bone erosion. CONCLUSION: Late complications may occur in the canal wall down mastoidectomy technique, after a long period of follow up in the absence of recurrent cholesteatoma. For this reason, it is advisable to look for a labyrinthine fistula in patient who develop vertigo a long time following mastoid surgery with a resultant radical cavity.
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ranking = 0.875
keywords = fistula
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19/73. "Spontaneous" perilymph fistula: a case report.

    A surgically documented case of barotrauma-induced perilymph fistula is presented in this case report. A brief review of the literature on this entity confirms the difficulty of making a definitive preoperative diagnosis in most instances. Clinical, audiometric, radiologic, and intraoperative findings are presented, and the classic presumed mechanisms for this uncommon cause of sudden sensorineural hearing loss are discussed. The presence of intact evoked otoacoustic emissions in an ear demonstrating a severe cochlear-type loss was considered helpful in narrowing the differential diagnosis in this case, and may suggest a productive avenue for future study.
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ranking = 0.625
keywords = fistula
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20/73. "Floating" labyrinth. Pathophysiology and treatment of perilymph fistula.

    Collapse of the membranous labyrinth of the pars superior is a morphological change observed in 50% of animals with experimentally produced perilymph fistula, although the extent and degree of the collapse may vary greatly. The moderately collapsed membranous labyrinth may drift with CSF and/or perilymph pressure changes and this may stimulate sensory cells of the utricle and/or semicircular canals if the sensory cells are intact and the collapsed wall is in contact with the otolithic membrane and/or cupula. This condition is termed "floating" labyrinth. Caloric irregularity is often observed in electronystagmograms recorded from animals with experimental perilymph fistula. This is also observed in patients with perilymph fistula. Partial destruction of the vestibular organs using argon laser was performed in a patient with perilymph fistula who was incapacitated because of persistent positional vertigo after closure of the oval window fistula. Irradiation of the argon laser beam was directed to the macula utriculi, utriculoampullary nerve and singular nerve. The hearing of the patient was maintained, and vertigo disappeared after laser labyrinthectomy.
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ranking = 1.125
keywords = fistula
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