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No4(4) 2021

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DOI 10.37219/2528-8253-2021-4-23
Srebniak IA, Sherbul OV, Pedachenko A
Peculiarities of clinical manifestations of perilymphatic fistulas and evaluation of the effectiveness of treatment in patients with middle ear cholesteatoma 
Srebniak Ilona A.
State Institution “Institute of otolaryngology named after Prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv, Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Leading Researcher
Doctor of Medical Sciences
E-mail: isribnyak@hotmail.com
Orchid ID: https://orcid.org/0000-0002-297-9415

Sherbul-Trokhymenko Olga V.
National military medical clinical center "Main military clinical hospital"
Clinic of Otorhinolaryngology
Surgical resident, Major of medical service
E-mail: olga_sherbul@yahoo.com
Orchid ID: https://orcid.org/0000-0002-5379-8795

Pedachenko Anastasia Evgenievna
State Institution “Institute of otolaryngology named after Prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”; Kyiv, Ukraine.
Ear Microsurgery and Otoneurosurgery Department
Researcher
Candidate of Medical Sciences
E-mail: apedachenko@ukr.net
Orchid ID: https://orcid.org/0000-0002-1256-0350

Abstract

By the analysis of the 410 histories of illnesses of patients in 38 (9,26 %) are set perilymphatic fistula of different localization. Clinical, radiological intraoperative differences and going are set near the choice of method reconstructively operation depending on the type of perilymphatic fistula.
After motion the extensive is certain more aggressive perilymphatic fistula is widespread, especially in the cases of cholesteatoma destruction of bone wall of labyrinth and simultaneous adhesion with a membranous labyrinth.
On the stage of preoperative diagnostics from data of КТ of temporal bones of perilymphatic fistula set for 21 (55,3 %) patients and determined almost for all patients with extensive widespread perilymphatic fistula (in 12 patients from 13) and in 9 patients with limit perilymphatic fistula.
By the preoperative inspection the positive test of fistula was determined only in 7 % patients.
After localization more often perilymphatic fistula was determined at the level of lateral semicircular canal – for 23 patients (60,5 %). Plural localization of perilymphatic fistula with the united defeat of bone wall two and more semicircular canals educed 5 patients (13,1 %).
The open variant of tympanoplasty is executed in 30 patients (78,9 %). The closed variant of tympanoplasty is in 6 (15,8 %) patients.
Early exposure of perilymphatic fistula after the presence of not staggered endost and in good time reconstructive surgical interference is conducted with optimal combined by microscopically-endoscopic visualization for patients with chronic otitis media with cholesteatome will allow saving a rumor and will prevent development of irreversible complications from the side of internal ear.

Keywords

chronic suppurative otitis media, cholesteatoma, perilymphatic fistula, diagnosis, treatment.


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