Imaging Analysis for Cholesteatoma Extension to the Perilymphatic Space in Labyrinth Fistulae.
Adult
Aged
Aged, 80 and over
Cholesteatoma, Middle Ear
/ diagnostic imaging
Female
Fistula
/ diagnostic imaging
Humans
Labyrinth Diseases
/ diagnostic imaging
Male
Middle Aged
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Semicircular Canals
/ diagnostic imaging
Tomography, X-Ray Computed
Cholesteatoma
computed tomography
hearing deterioration
labyrinth fistula
perilymphatic space
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
20
04
2020
revised:
16
07
2020
accepted:
21
07
2020
pubmed:
18
8
2020
medline:
10
4
2021
entrez:
18
8
2020
Statut:
ppublish
Résumé
Disturbed perilymph behind a labyrinth fistula can lead to hearing deterioration; thus, delicate manipulation is required during surgery for cholesteatomatous fistulae with matrix extension to the perilymphatic space (EPS). However, it remains challenging to identify the EPS preoperatively. This study aimed to evaluate the diagnostic value of computed tomography (CT) for preoperative prediction of the EPS of cholesteatomatous fistulae. Retrospective study. We included serial high-resolution CT images showing a cholesteatomatous bone defect in the lateral semicircular canal (LSC) requiring mastoidectomy. CT and intraoperative findings were analyzed retrospectively. Using axial CT planes, we evaluated the length and angle between the margins of bone defects. Receiver operating characteristic (ROC) curves were constructed to determine the cutoff points. We extracted data from 30 bone defects, of which six (20.0%) showed EPS intraoperatively. Bone defects with EPS (n = 6) had significantly greater length and angle values than those without EPS (n = 24) (P < .001 for both, Wilcoxon rank sum test). For length and angle, the area under the curve was 0.944 (95% confidence interval [CI]: 0.858-1.000) and 0.951 (95% CI: 0.875-1.000), respectively, according to the ROC analysis, and the optimal cutoff values were 3.65 mm and 71.6°, respectively, with 100% sensitivity and 91.67% specificity for both. Results demonstrated that a length >3.65 mm and an angle >71.6° for LSC bone defects on axial CT images are reliable diagnostic markers of EPS. Preoperative high-resolution CT analysis can provide surgeons with a more conscientious preparation for handling deeper labyrinth fistulae. 4 Laryngoscope, 131:E1301-E1307, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E1301-E1307Informations de copyright
© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
Références
Copeland BJ, Buchman CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol 2003;24:51-60.
Smyth GD, Kerr AG. Sensorineural hearing after removal of cholesteatoma from labyrinthine fistulae. J Otolaryngol 1976;5:364-370.
Sheehy JL, Brackmann DE. Cholesteatoma surgery: management of the labyrinthine fistula: a report of 97 cases. Laryngoscope 1979;89:78-87.
Sheehy JL. Management of labyrinthine fistula. Clin Otolaryngol 1978;3:405-414.
Sanna M, Zini C, Gamoletti R, Taibah AK, Russo A, Scandellari R. Closed versus open technique in the management of labyrinthine fistula. Am J Otol 1988;9:470-475.
Kobayashi T, Sakurai T, Okitsu T, et al. Labyrinthine fistulae caused by cholesteatoma. Improved bone conduction by treatment. Am J Otol 1989;10:5-10.
Law KP, Smyth GD, Kerr AG. Fistulae of the labyrinth treated by staged combined approach tympanoplasty. J Laryngol Otol 1975;89:471-478.
Gacek RR. The surgical management of labyrinthine fistulae in chronic otitis media with cholesteatoma. Ann Otol Rhinol Laryngol 1974;83:1-19.
Palva T, Ramsay H. Treatment of labyrinthine fistula. Arch Otolaryngol Head Neck Surg 1989;115:804-806.
Ritter FN. Chronic suppurative otitis media and the pathologic labyrinthine fistula. Laryngoscope 1970;80:1025-1035.
Ikeda R, Nakaya K, Oshima H, Oshima T, Kawase T, Kobayashi T. Effect of aspiration of perilymph during stapes surgery on the endocochlear potential of guinea pig. Otolaryngol Head Neck Surg 2011;145:801-805.
Moon IS, Kwon MO, Park CY, et al. Surgical management of labyrinthine fistula in chronic otitis media with cholesteatoma. Auris Nasus Larynx 2012;39:261-264.
Dornhoffer JL, Milewski C. Management of the open labyrinth. Otolaryngol Head Neck Surg 1995;112:410-414.
Stephenson MF, Saliba I. Prognostic indicators of hearing after complete resection of cholesteatoma causing a labyrinthine fistula. Eur Arch Otorhinolaryngol 2011;268:1705-1711.
Quaranta N, Liuzzi C, Zizzi S, Dicorato A, Quaranta A. Surgical treatment of labyrinthine fistula in cholesteatoma surgery. Otolaryngol Head Neck Surg 2009;140:406-411.
Palva T, Karja J, Palva A. Opening of the labyrinth during chronic ear surgery. Arch Otolaryngol 1971;93:75-78.
Fuse T, Tada Y, Aoyagi M, Sugai Y. CT detection of facial canal dehiscence and semicircular canal fistula: comparison with surgical findings. J Comput Assist Tomogr 1996;20:221-224.
Young M, Tono T, Olszewska E, et al. EAONO/JOS joint consensus statements on the definitions, classification and staging of middle ear cholesteatoma. J Int Adv Otol 2017;13:1-8.
Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:186-187.
Kobayashi T, Sato T, Toshima M, Ishidoya M, Suetake M, Takasaka T. Treatment of labyrinthine fistula with interruption of the semicircular canals. Arch Otolaryngol Head Neck Surg 1995;121:469-475.
Ostri B, Bak-Pedersen K. Surgical management of labyrinthine fistulae in chronic otitis media with cholesteatoma by a one-stage closed technique. ORL J Otorhinolaryngol Relat Spec 1989;51:295-299.
Freeman P. Fistula of the lateral semicircular canal. Clin Otolaryngol 1978;3:315-321.
Yamauchi D, Yamazaki M, Ohta J, et al. Closure technique for labyrinthine fistula by “underwater” endoscopic ear surgery. Laryngoscope 2014;124:2616-2618.
Baylan MY, Yılmaz Ü, Akkuş Z, Topcu I. Assessment of bone conduction thresholds after surgical treatment in patients with labyrinthine fistula. Turk Arch Otorhinolaryngol 2018;56:89-94.
Sone M, Yoshida T, Naganawa S, et al. Comparison of computed tomography and magnetic resonance imaging for evaluation of cholesteatoma with labyrinthine fistulae. Laryngoscope 2012;122:1121-1125.
Ikeda R, Kobayashi T, Kawase T, Oshima T, Sato T. Risk factors for deterioration of bone conduction hearing in cases of labyrinthine fistula caused by middle ear cholesteatoma. Ann Otol Rhinol Laryngol 2012;121:162-167.
Meyer A, Bouchetemblé P, Costentin B, Dehesdin D, Lerosey Y, Marie JP. Lateral semicircular canal fistula in cholesteatoma: diagnosis and management. Eur Arch Otorhinolaryngol 2016;273:2055-2063.
Rah YC, Han WG, Joo JW, et al. One-stage complete resection of cholesteatoma with labyrinthine fistula: hearing changes and clinical outcomes. Ann Otol Rhinol Laryngol 2018;127:241-248.
Kvestad E, Kvaerner KJ, Mair IW. Labyrinthine fistula detection: the predictive value of vestibular symptoms and computerized tomography. Acta Otolaryngol 2001;121:622-626.