LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS
Introduction. Clinical and diagnostic approaches to the detection and treatment of perilymphatic fistulas (PLF) have remained controversial in modern otolaryngology for the past five decades. The main approaches in the patient treatment protocol are the identification of PLF, the time of its detecti...
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State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2025-01-01
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| Series: | Клінічна та профілактична медицина |
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| Online Access: | https://cp-medical.com/index.php/journal/article/view/512 |
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| author | Ilona A. Srebniak Olga V. Sherbul-Trokhymenko |
| author_facet | Ilona A. Srebniak Olga V. Sherbul-Trokhymenko |
| author_sort | Ilona A. Srebniak |
| collection | DOAJ |
| description | Introduction. Clinical and diagnostic approaches to the detection and treatment of perilymphatic fistulas (PLF) have remained controversial in modern otolaryngology for the past five decades. The main approaches in the patient treatment protocol are the identification of PLF, the time of its detection, and the timeliness of treatment.
Aim. To evaluate the clinical and functional outcomes of treatment in patients with unilateral sudden and acute sensorineural hearing loss, fluctuating and sensorineural deafness, as well as perilymphatic fistulas by assessing the effectiveness of minimally invasive diagnostic tympanotomy with one-step labyrinthine window plastic surgery.
Materials and methods. Analysis of long-term follow-up treatment outcomes of 37 patients with PLF in labyrinth windows areas who underwent surgery (minimally invasive otomicrosurgical intervention with optimal combined microscopic and endoscopic visualization and closure of the affected area) in 2016–2020 was conducted. The perilymphatic fistula was repaired using a free connective tissue-fat flap with additional sealing of the labyrinthine windows area with fragments of gelaspon soaked with dexamethasone solution. In follow-up all patients were examined by otomicroscopy, pure tone threshold audiometry, impedancemetry, vestibulometry, temporal bones CT scans and magnetic resonance imaging of the brain.
Results. The long-term follow-up period is composed of 18–24 months. The absence of dizziness after our treatment approach was noted in 28 patients (76 %). In 22 patients (59 %), stable values of improved bone conduction sound perception thresholds were determined at all studied frequencies within 18–24 months after surgical treatment. The average threshold values for bone-conducted sounds were (26.05±6.2) dB. The decrease in air conduction perception thresholds had more pronounced values at frequencies of 500 Hz – 2 kHz. Fluctuating hearing loss persisted in 6 (16 %) patients. In 7 (19 %) patients, hearing at the studied frequencies improved within 5–10 dB, however, instability and uncertainty were noted when walking in the dark. Two patients had no improvement in hearing either in the immediate or long-term follow-up period.
Conclusions. Thus, timely diagnostic determination and treatment with PLF closure ensures improvement of vestibular and auditory function with obtaining a positive stable clinical and functional result in the dynamics of the postoperative period. |
| format | Article |
| id | doaj-art-1f4eab26d4f840909fcbc9a40b086246 |
| institution | OA Journals |
| issn | 2616-4868 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department |
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| series | Клінічна та профілактична медицина |
| spelling | doaj-art-1f4eab26d4f840909fcbc9a40b0862462025-08-20T02:38:21ZengState Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative DepartmentКлінічна та профілактична медицина2616-48682025-01-011425110.31612/2616-4868.1.2025.05512LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWSIlona A. Srebniak0Olga V. Sherbul-Trokhymenko1State Institution “O.S. Kolomiychenko Institute of Otolaryngology of the National Academy of Medical Sciences of Ukraine”, Kyiv, UkraineNational military medical centre “Main military clinical hospital” , Kyiv, UkraineIntroduction. Clinical and diagnostic approaches to the detection and treatment of perilymphatic fistulas (PLF) have remained controversial in modern otolaryngology for the past five decades. The main approaches in the patient treatment protocol are the identification of PLF, the time of its detection, and the timeliness of treatment. Aim. To evaluate the clinical and functional outcomes of treatment in patients with unilateral sudden and acute sensorineural hearing loss, fluctuating and sensorineural deafness, as well as perilymphatic fistulas by assessing the effectiveness of minimally invasive diagnostic tympanotomy with one-step labyrinthine window plastic surgery. Materials and methods. Analysis of long-term follow-up treatment outcomes of 37 patients with PLF in labyrinth windows areas who underwent surgery (minimally invasive otomicrosurgical intervention with optimal combined microscopic and endoscopic visualization and closure of the affected area) in 2016–2020 was conducted. The perilymphatic fistula was repaired using a free connective tissue-fat flap with additional sealing of the labyrinthine windows area with fragments of gelaspon soaked with dexamethasone solution. In follow-up all patients were examined by otomicroscopy, pure tone threshold audiometry, impedancemetry, vestibulometry, temporal bones CT scans and magnetic resonance imaging of the brain. Results. The long-term follow-up period is composed of 18–24 months. The absence of dizziness after our treatment approach was noted in 28 patients (76 %). In 22 patients (59 %), stable values of improved bone conduction sound perception thresholds were determined at all studied frequencies within 18–24 months after surgical treatment. The average threshold values for bone-conducted sounds were (26.05±6.2) dB. The decrease in air conduction perception thresholds had more pronounced values at frequencies of 500 Hz – 2 kHz. Fluctuating hearing loss persisted in 6 (16 %) patients. In 7 (19 %) patients, hearing at the studied frequencies improved within 5–10 dB, however, instability and uncertainty were noted when walking in the dark. Two patients had no improvement in hearing either in the immediate or long-term follow-up period. Conclusions. Thus, timely diagnostic determination and treatment with PLF closure ensures improvement of vestibular and auditory function with obtaining a positive stable clinical and functional result in the dynamics of the postoperative period.https://cp-medical.com/index.php/journal/article/view/512perilymphatic fistulasensorineural hearing lossfluctuating hearing lossdiagnostic tympanotomy |
| spellingShingle | Ilona A. Srebniak Olga V. Sherbul-Trokhymenko LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS Клінічна та профілактична медицина perilymphatic fistula sensorineural hearing loss fluctuating hearing loss diagnostic tympanotomy |
| title | LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS |
| title_full | LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS |
| title_fullStr | LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS |
| title_full_unstemmed | LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS |
| title_short | LONG-TERM RESULTS OF THE TREATMENT OF PATIENTS WITH PERILYMPHATIC FISTULAS LOCATED IN THE AREAS OF THE LABYRINTH WINDOWS |
| title_sort | long term results of the treatment of patients with perilymphatic fistulas located in the areas of the labyrinth windows |
| topic | perilymphatic fistula sensorineural hearing loss fluctuating hearing loss diagnostic tympanotomy |
| url | https://cp-medical.com/index.php/journal/article/view/512 |
| work_keys_str_mv | AT ilonaasrebniak longtermresultsofthetreatmentofpatientswithperilymphaticfistulaslocatedintheareasofthelabyrinthwindows AT olgavsherbultrokhymenko longtermresultsofthetreatmentofpatientswithperilymphaticfistulaslocatedintheareasofthelabyrinthwindows |