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• W4200358510 abstract "Cochlear fistula (CF) is a rare finding, usually associated with extensive middle ear cholesteatoma. There is agreement on the fact that removing the cholesteatoma matrix on a CF exposes the ear to a high risk of sensorineural hearing loss or dead ear. The aim of the study is to describe the presentation, possible treatment strategies and related outcomes for patients with CF in chronic otitis media (COM).The study considers a retrospective case series of patients with CF diagnosis supported by CT-scan and intraoperative/otoscopic evidence.Five cases of CF were identified, 4 associated with cholesteatoma and 1 associated with non-cholesteatomatous COM. Two patients presenting with anacusis underwent a subtotal petrosectomy. Two patients with useful hearing underwent a radical mastoidectomy in order to preserve the cholesteatoma matrix on the promontorium. One patient with good hearing and COM was treated conservatively.Conservative management should be considered for rare cases of CF in COM with residual hearing. Matrix preservation through radical/modified radical mastoidectomy is strongly advised in the presence of useful preoperative bone conduction. Subtotal petrosectomy should be considered the preferred option in presence of cholesteatoma with preoperative profound hearing loss.Gestione della fistola cocleare e il ruolo dell’udito: report di 5 casi.La fistola cocleare (FC) è una rara entità, solitamente associata a colesteatoma dell’orecchio medio. Vi è generale accordo in letteratura sul fatto che la rimozione della matrice colesteatomatosa da una FC determini elevato rischio di ipoacusia neurosensoriale o anacusia. Obiettivo dello studio è descrivere manifestazioni, possibili trattamenti e prognosi per pazienti affetti da FC.Serie retrospettiva di casi clinici di fistola cocleare confermati da TC e da riscontro intraoperatorio o endoscopico.Di 5 casi identificati, 4 si associavano a colesteatoma. Di questi, 2 pazienti anacusici venivano sottoposti a petrosectomia subtotale, mentre 2 pazienti udenti venivano sottoposti a intervento di radicale con preservazione della matrice sul promontorio. Il solo caso di FC associato a otite cronica non-colesteatomatosa (OMC) e con buon udito residuo veniva trattato conservativamente.Per quei rari casi di FC associati a OMC con buon udito residuo dovrebbe essere considerato un trattamento conservativo. In caso di via ossea preoperatoria protesizzabile, è fortemente indicata la preservazione della matrice di colesteatoma mediante mastoidectomia radicale o radicale modificata. In presenza di colesteatoma con perdita uditiva profonda pre-operatoria, una petrosectomia subtotale dovrebbe essere il trattamento di scelta." @default.
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• W4200358510 date "2021-12-01" @default.
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• W4200358510 title "Management of cochlear fistula and the role of hearing: a five-case report" @default.
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• W4200358510 doi "https://doi.org/10.14639/0392-100x-n1237" @default.
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