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Objective: This study aimed to compare the pre- and post-operative vestibular and equilibrium functions of patients with cholesteatoma-induced labyrinthine fistulas who underwent different management methods., Methods: Data from 49 patients with cholesteatoma-induced labyrinthine fistulas who underwent one of three surgical procedures were retrospectively analysed. The three management options were fistula repair, obliteration and canal occlusion., Results: Patients underwent fistula repair ( n = 8), canal occlusion ( n = 18) or obliteration procedures ( n = 23). Patients in the fistula repair and canal occlusion groups suffered from post-operative vertigo and imbalance, which persisted for longer than in those in the obliteration group. Despite receiving different management strategies, all patients achieved complete recovery of equilibrium functions through persistent efforts in rehabilitation exercises., Conclusion: Complete removal of the cholesteatoma matrix overlying the fistula is reliable for preventing iatrogenic hearing deterioration due to unremitting labyrinthitis. Thus, among the three fistula treatments, obliteration is the optimal method for preserving post-operative vestibular functions.

Objective: To measure the outcomes of laser treatment of cholesteatoma covering cochlear and vestibular fistulas., Methods: Cholesteatoma matrix over the fistula was denatured; the power density was sufficient only to gradually heat, but not vaporise, the keratin-forming matrix. The denaturing speed was controlled so that the integrity of the fistula cover was maintained. The change in bone conduction threshold and the residual rate of cholesteatoma at the fistula were measured., Results: Thirty-six fistulas were assessed. There were seven cochlear fistulas. All were 5 mm or less in maximum length. For the entire group, the average change in bone conduction threshold was -0.3 dB. For cochlear fistulas, the average change in bone conduction was + 0.2 dB. The distribution of hearing results for the entire group was Gaussian; the apparent changes in hearing could be attributed to errors associated with testing. All patients underwent second-stage surgery. In all cases, the cholesteatoma was completely cleared from the fistula site. There were no facial palsies., Conclusion: Laser denaturing of cholesteatoma matrix over fistulas measuring 5 mm or less of vestibular apparatus and the cochlea is effective at eliminating cholesteatoma, and is not associated with cochlear hearing loss or facial palsy.

Objective: A distinct subgroup of patients, presenting with apparently spontaneous onset of vertigo, is described., Results: Although vestibular evaluation revealed caloric weakness, the proximate cause of vertigo was not labyrinthine dysfunction, but rather the loss of vestibular compensation for an older and previously compensated labyrinthine injury., Conclusion: Instead of addressing the vestibular weakness, effective management needs to focus on the condition that has caused the loss of compensation.

Objective: To determine signs and symptoms for superior canal dehiscence syndrome caused by the superior petrosal sinus., Methods: A review of the English-language literature on PubMed and Embase databases was conducted, in addition to a multi-centre case series report., Results: The most common symptoms of 17 patients with superior petrosal sinus related superior canal dehiscence syndrome were: hearing loss (53 per cent), aural fullness (47 per cent), pulsatile tinnitus (41 per cent) and pressure-induced vertigo (41 per cent). The diagnosis was made by demonstration of the characteristic bony groove of the superior petrosal sinus and the 'cookie bite' out of the superior semicircular canal on computed tomography imaging., Conclusion: Pulsatile tinnitus, hearing loss, aural fullness and pressure-induced vertigo are the most common symptoms in superior petrosal sinus related superior canal dehiscence syndrome. Compared to superior canal dehiscence syndrome caused by the more common apical location of the dehiscence, pulsatile tinnitus and exercise-induced vertigo are more frequent, while sound-induced vertigo and autophony are less frequent. There is, however, considerable overlap between the two subtypes. The distinction cannot as yet be made on clinical signs and symptoms alone, and requires careful analysis of computed tomography imaging.

Objective: We report a case of bilateral pneumolabyrinth presenting as sudden, bilateral deafness, without temporal bone fracture, after a fall., Case Report: A 49-year-old man presented with sudden, bilateral deafness and whirling vertigo, without any other neurological manifestations. Temporal bone computed tomography clearly demonstrated the presence of air in the vestibule and cochlea on both sides. However, there was no definite fracture line, ossicular chain anomaly or soft tissue density in the temporal bone or middle-ear cavity. The patient was treated conservatively. Unfortunately, there was no improvement in his hearing., Conclusion: Pneumolabyrinth is an uncommon condition in which air is present in the vestibule or cochlea. It is rarely found, even with fractures violating the otic capsule or with transverse fractures of the temporal bone. In addition, its bilateral occurrence is extremely rare. In this article, we describe a case of bilateral pneumolabyrinth presenting as sudden, bilateral deafness, without temporal bone fracture, an occurrence which has not previously been reported.

Objective: Systemic autoimmune diseases, including ulcerative colitis, may involve the inner ear. Several ulcerative colitis cases presenting with sensorineural hearing loss have been reported. We report the T2-weighted, three-dimensional, inner-ear magnetic resonance imaging findings in the inner ears of two such patients., Methods: Case reports and a review of the literature concerning autoimmune disease and sensorineural hearing loss are presented., Results: We describe two cases of ulcerative colitis with sensorineural hearing loss in which three-dimensional magnetic resonance imaging revealed obliteration of the inner ear. Those inner ears with obliteration had severe hearing loss, and responded poorly to steroid therapy., Conclusion: To our knowledge, there has been no previous published report of the T2-weighted, inner-ear magnetic resonance imaging findings of cases of ulcerative colitis with sensorineural hearing loss. This paper represents the first published report in the world literature of inner-ear obliteration in such patients. Three-dimensional magnetic resonance imaging is beneficial in elucidating the pathophysiology of the inner-ear involvement seen in ulcerative colitis.

Traumatic luxation of the stapes into the vestibule is a rare entity, and the disease complicated with pneumolabyrinth is extremely rare. We report the case of a 72-year-old woman with pneumolabyrinth associated with a stapediovestibular dislocation. The patient presented with vertigo and nystagmus following penetrating trauma to the middle ear. High resolution computed tomography scans demonstrated air in the vestibule and dislocation of the stapes. Exploratory tympanotomy demonstrated oozing of the perilymph from the oval window and depression of the stapes into the vestibule. Pneumolabyrinth and stapes luxation detected by high resolution computed tomography should be predictive of a perilymphatic fistula.

A labyrinthine fistula is a frequent complication of long-standing unsafe chronic suppurative otitis media. It is characterized by a slowly progressive erosion of the bony labyrinth. In this paper we present our observations regarding the diagnosis and management in 50 patients with unsafe chronic suppurative otitis media with labyrinthine fistula.

Ossification of the inner ear is the result of multifactorial pathogeneses, such as infection or malignant infiltration, and otosclerosis. Ossification of the inner ear spaces is a well documented sequela of suppurative labyrinthitis. In this study of human temporal bones, sections from 14 patients (28 temporal bones) were studied. In addition to the osseous tissue within the inner ear, findings included neoplasms, otosclerosis, otitis media, trauma, and Fabry's disease. We have attempted to correlate these conditions and their influence on the formation of osseous tissue within the spaces of the inner ear. Tympanogenic infection and vascular compromise were found to play an important role in ossification. The scala tympani of the basal turn of the cochlea was frequently the site involved.

We report a case of endolymphatic hydrops preceded by haemodialysis in the contralateral ear of a patient with known Menière's disease, and discuss the possible mechanism. It is suggested that the sudden decrease of plasma osmolality during haemodialysis acts as a reverse glycerol test. The audiometric and electrophysiological recordings pre- and post-dialysis and the induction of the Menière's triad of symptoms during dialysis, were strongly indicative of the presence of endolymphatic hydrops.

An otopathological analysis of three cases of viral labyrinthitis was performed. Six temporal bones cut in serial sections were available for this study. According to the degree of degenerative changes in various parts of the inner ear two types of morphologically distinct labyrinthitis after measles are presented: the first one with the port of entrance through the internal auditory meatus and characterized by, first and most significantly, changes in the spiral ganglion cells; and the second, as described previously by Lindsay, with the port of entrance of the virus in the inner ear through the stria vascularis, with degenerative changes in various structures within the endolymphatic duct.

Occlusion of the anterior vestibular artery has resulted in severe degeneration and new bone formation limited to the utricle, saccule, and superior and lateral semicircular canals. Depriving the inner ear of its main blood supply, i.e. the internal auditory artery, has resulted in severe degeneration and ossification of the entire membranous labyrinth, except the endolymphatic duct and sac. A more severe cochlear sclerosis was seen when both arterial and venous blood supplies to the cochlea were occluded. The implications of these findings on the etiology and management of inner ear disorders are emphasized.