Assessment of Bone Conduction Thresholds After Surgical Treatment in Patients with Labyrinthine Fistula

Objective: This study aimed to analyze the bone conduction thresholds before and after surgery in chronic otitis media patients with cholesteatoma who had labyrinthine fistula and whose cholesteatoma matrix had been completely cleaned. Methods: The study was performed between 2013 to 2017 with 23 chronic otitis media patients who had labyrinthine fistula with cholesteatoma and who were operated at the Department of Otorhinolaryngology of Dicle University School of Medicine. Patients were assessed by anamnesis and examination and when necessary, by temporal computerized tomography and diffusion magnetic resonance imaging. Bone conduction thresholds at frequencies of 500, 1000, 2000, and 4000 Hz were determined by audiometric examination and they were compared before and after surgery. Results: Of the 23 patients, 12 were female and 11 were male; their age range was 10-55 (26.04 +/- 14.13) years. In the post-operative period, it was possible to conduct audiological follow-up on 20 patients. In these follow-ups, 16 patients showed no change in bone conduction thresholds, two patients showed worsening, and two showed improvement. When pre-and post-operative bone conduction thresholds at each frequency were compared separately, no significant difference was found (p=0.937). No statistically significant difference was found between the pre-and post-operative means at the four frequencies (p=0.712). Conclusion: In this study, we found that to reduce complications relating to cholesteatoma, it might be necessary to completely remove the matrix especially in the case of type 1 and 2 labyrinthine fistulas.