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Perilymphatic fistulas: can we predict the diagnosis?
Alzahrani, Musaed; Fadous, Raphaelle; Dufour, Jean-Jacque; Saliba, Issam.
Afiliación
  • Alzahrani M; Division of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center (CHUM), University of Montreal, 1560, Sherbrooke East Street, Montreal, QC, H2L 4M1, Canada.
Eur Arch Otorhinolaryngol ; 272(8): 1885-91, 2015 Aug.
Article en En | MEDLINE | ID: mdl-24652117
This study intends to identify factors that could better predict the diagnosis of perilymphatic fistula (PLF) since exploration surgery is currently the only confirmatory method. This retrospective chart review in a tertiary care center is based on all 71 available patient files operated for a suspicion of PLF between 1983 and 2012. History of predisposing factors, clinical findings and investigations were documented pre- and postoperatively. Patients were divided according to intraoperative findings into two groups: group I (fistula negative) and group II (fistula positive). In addition, group II was divided into two subgroups: patients with or without a history of stapedectomy. Both groups were demographically similar. With the exception of history of previous partial stapedectomy (p = 0.04), no statistical difference could be identified in predisposing factors and in clinical findings between the two groups. The evolution of symptoms showed an overall improvement of vestibular symptoms (91 %) and cochlear symptoms (53 %) postoperatively. Audiograms showed a significant improvement postoperatively in the pure tone audiometry and bone conduction threshold of group II while the air-bone gap and speech discrimination score did not improve. Group I did not show any significant improvement postoperatively in any audiogram parameter. This study failed to identify factors that could better predict the diagnosis of PLF. However, it shows that middle ear exploration with oval and round window obliteration is effective in PLF especially to decrease vestibular symptoms even when fistula is unidentified intraoperatively.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cirugía del Estribo / Oído Medio / Fístula / Oído Interno / Enfermedades del Laberinto Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cirugía del Estribo / Oído Medio / Fístula / Oído Interno / Enfermedades del Laberinto Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania