Opening of the Labyrinth During Chronic Ear Surgery

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Abstract
In 830 radical operations inner ear fistula was encountered in 30 (3.6%) ears; 18 were without symptoms, five had serous, and seven purulent labyrinthitis. Cholesteatoma membrane was left on top of fistula in 13 ears. All retained hearing or improved but one ear became deaf three years later due to purulent labyrithitis. Removal of cholesteatoma was performed in ten ears with hearing: seven retained hearing or improved, one became worse, while two became deaf when labyrinth was accidentally entered. Promontory fistulae had a poorer prognosis than horizontal canal fistulae. Accidental opening of labyrinth occurred in 12 (1.4%) ears. Four had good hearing postoperatively. Three lost hearing 3 to 11 months postoperatively. Both fistula region and stapes foot plate area should be dissected as last steps in chronic ear surgery to protect hearing even if accidental opening occurs.

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