Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear

Background. False negative fistula testing in patients with chronic suppurative otitis media is a dilemma when proceeding to surgery. It is imperative to rule out a dead labyrinth or a mass effect secondary to the cholesteatoma in an otherwise normally functioning inner ear. We present a case series...

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Main Authors: Ricardo D’Albora, Ligia Silveira, Sergio Carmona, Nicolas Perez-Fernandez
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2017/2919463
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author Ricardo D’Albora
Ligia Silveira
Sergio Carmona
Nicolas Perez-Fernandez
author_facet Ricardo D’Albora
Ligia Silveira
Sergio Carmona
Nicolas Perez-Fernandez
author_sort Ricardo D’Albora
collection DOAJ
description Background. False negative fistula testing in patients with chronic suppurative otitis media is a dilemma when proceeding to surgery. It is imperative to rule out a dead labyrinth or a mass effect secondary to the cholesteatoma in an otherwise normally functioning inner ear. We present a case series of three patients in whom a bedside vestibuloocular reflex (VOR) evaluation using a head impulse test was used successfully for further evaluation prior to surgery. Results. In all three cases with a false negative fistula test we were able to further evaluate at the bedside and were not only able to register the abnormal VOR but also localize its deterioration to a particular semicircular canal eroded by the fistula. Conclusion. Vestibuloocular reflex evaluation is mandatory in patients with suspected labyrinthine fistula due to cholesteatoma of the middle ear before proceeding to surgery. We demonstrate successful use of a bedside head impulse test for further evaluation prior to surgery in patients with false negative fistula test.
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institution Kabale University
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spelling doaj-art-abe556424d3b4ca7b43640209a4f360f2025-08-20T03:39:13ZengWileyCase Reports in Otolaryngology2090-67652090-67732017-01-01201710.1155/2017/29194632919463Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle EarRicardo D’Albora0Ligia Silveira1Sergio Carmona2Nicolas Perez-Fernandez3Department of Otorhinolaryngology, Hospital de Clínicas, Facultad de Medicina UDELAR, Montevideo, UruguayDepartment of Otorhinolaryngology, Hospital de Clínicas, Facultad de Medicina UDELAR, Montevideo, UruguayDepartment of Neuro-Otology, Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, ArgentinaDepartment of Otorhinolaryngology, Clínica Universidad de Navarra, Pamplona, SpainBackground. False negative fistula testing in patients with chronic suppurative otitis media is a dilemma when proceeding to surgery. It is imperative to rule out a dead labyrinth or a mass effect secondary to the cholesteatoma in an otherwise normally functioning inner ear. We present a case series of three patients in whom a bedside vestibuloocular reflex (VOR) evaluation using a head impulse test was used successfully for further evaluation prior to surgery. Results. In all three cases with a false negative fistula test we were able to further evaluate at the bedside and were not only able to register the abnormal VOR but also localize its deterioration to a particular semicircular canal eroded by the fistula. Conclusion. Vestibuloocular reflex evaluation is mandatory in patients with suspected labyrinthine fistula due to cholesteatoma of the middle ear before proceeding to surgery. We demonstrate successful use of a bedside head impulse test for further evaluation prior to surgery in patients with false negative fistula test.http://dx.doi.org/10.1155/2017/2919463
spellingShingle Ricardo D’Albora
Ligia Silveira
Sergio Carmona
Nicolas Perez-Fernandez
Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
Case Reports in Otolaryngology
title Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
title_full Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
title_fullStr Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
title_full_unstemmed Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
title_short Diagnostic Bedside Vestibuloocular Reflex Evaluation in the Setting of a False Negative Fistula Test in Cholesteatoma of the Middle Ear
title_sort diagnostic bedside vestibuloocular reflex evaluation in the setting of a false negative fistula test in cholesteatoma of the middle ear
url http://dx.doi.org/10.1155/2017/2919463
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