Long-term deterioration of bone-conduction hearing level in patients with labyrinthine fistula.

OBJECTIVE: Although many reports describe the short-term hearing outcomes of surgically managed labyrinthine fistulae, the long-term results remain unknown. We reviewed the long-term postoperative hearing outcomes of 14 ears of patients with cholesteatoma and labyrinthine fistulae. METHODS: Between 1996 and 2010, 84 patients with cholesteatoma and labyrinthine fistula underwent tympanoplasty at Hyogo College of Medicine Hospital. Fistulae were located in the lateral semicircular canal in all patients and in the superior semicircular canal in one. Fourteen patients were followed up for more than 5 years. RESULTS: The postoperative air-bone gap was ≤10dB in one patient, between 11 and 20dB in seven, between 21 and 30dB in four, and ≥31dB in two. Mean bone-conduction hearing levels on the operated side had deteriorated by 3, -1 and -2dB at 1, 2 and 4kHz, respectively at 1 year postoperatively, and by 8, 6 and 2dB at 1, 2 and 4kHz, at 5 years postoperatively. Bone-conduction hearing levels at 1 and 2kHz were significantly deteriorated at 5 years postoperatively, compared with baseline and 1 year (P<0.05).

Preoperative assessment of taste function in patients with middle ear disease.

OBJECTIVE: To identify differences in taste function among patients with chronic otitis media, cholesteatoma, and noninflammatory disease before middle ear surgery. STUDY DESIGN: Retrospective analysis. SETTING: Tertiary referral hospital. PATIENTS: Two hundred thirty ears underwent primary middle ear surgery from January 2006 to December 2010. The subjects consisted of 84 men and 146 women with ages ranging from 20 to 60 years (mean, 43.9 yr). There were 95 ears with chronic otitis media, 61 ears with pars flaccida retraction-type cholesteatoma, 22 ears with pars tensa retraction-type cholesteatoma, and 52 ears with noninflammatory diseases such as otosclerosis and ossicular anomalies. MAIN OUTCOME MEASURE: The patients underwent taste testing using electrogustometry and the filter paper disk method in the regions controlled by the chorda tympani nerve. RESULTS: None of the patients complained of taste dysfunction before middle ear surgery. Among the 4 groups, the patients with pars tensa retraction-type cholesteatoma displayed the highest electrogustometry threshold. The filter paper disk method did not detect any significant differences among the 4 groups. CONCLUSION: Our findings suggest that the filter paper disk scores of all taste qualities (sweet, salty, sour, and bitter tastes) are not deteriorated preoperatively during chronic inflammation in the middle ear and that taste function is affected most in patients with pars tensa retraction-type cholesteatoma.