Matrix removal of labyrinthine fistulae by non-suction technique with intraoperative dexamethasone injection

Abstract

Conclusion: Matrix removal by a non-suction technique with intraoperative dexamethasone injection is a safe and effective management modality, regardless of fistula size. Objective: Our goal was to evaluate the outcome of hearing treated by non-suction technique with intraoperative dexamethasone injection. Methods: This was a retrospective chart review of 720 mastoidectomy cases for cholesteatoma, performed at our tertiary otolaryngologic care centers between 2005 and 2012. A total of 17 patients with a unilateral labyrinthine fistula were encountered. Results: There was no recurrent cholesteatoma in any of the patients. In all cases, the matrix was removed by intraoperative dexamethasone injection with a bimanual non-suction technique, regardless of the fistula size. None of the patients showed deteriorated bone conduction (BC). Averaged BC was unchanged (n = 13) or improved (n = 4) in all patients and did not decrease by 10 dB more in any patient. The mean threshold of postoperative BC was significantly improved compared with preoperative mean threshold. Fistulae on the preoperative CT scans ranged from 1.41 to 7.12 mm and averaged 2.89 mm. There was no correlation between the fistula size and the postoperative BC level. Even with a large fistula, postoperative hearing preservation was possible with one-stage matrix removal.

Keywords::

• Fistula size
• bone conduction
• hearing preservation

Acknowledgements

This study was supported by a National Research Foundation (NRF) grant funded from the Korea government (MEST) through the Research Center for Resistant Cells (R13-2003-009) and by Fishery Commercialization Technology Development Program, Minstry for Food, Agriculture, Forestry and Fisheries, Republic of Korea.

Declaration of interest : The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.