Abstract
SummaryPerilymphatic fistulas still represent a major treatment challenge. In some cases, its surgical closure can reduce auditory and vestibular sequelae.Aimto compare the behavior of cochlear window perilymphatic fistulas in guinea pigs as to their natural evolution and immediate surgical closure.Materials and MethodsExperimental study. Forty guinea pigs were submitted to cochlear window membrane lesion and randomly broken down into two groups: open fistula (OF) and surgically closed fistula (SCF). We found the summation potential (SP) and action potential (AP) latencies and amplitudes and the SP/AP ratio at three times: pre-fistula (PRE), immediate post-fistula (IPF) and late post-fistula (LPF).ResultsThere was a significant drop in amplitudes and raise in SP and AP latencies among the times studied. As to the SP/AP ratios, there was a reduction between PRE and IPF, both were significant. There was no behavior difference between the OF and SCF.ConclusionsWithin the time frame considered, guinea pigs submitted to cochlear window membrane lesions evolved with a worsening in potentials and latencies. Despite the partial improvement in electrophysiological parameters, surgical closure did not prove statistically more effective than natural evolution.
Highlights
Considered as an abnormal shunt between the cochlea and the middle ear cavity, the perilymphatic fistula (PF) can be the result of chronic otitis media complications, head injury, acoustic trauma and barotrauma, amongst others, and we must stress the fistulas caused by congenital malformations responsible for repetition meningitis spells, the iatrogenic ones and the ones related to ear surgery, especial stapes surgeries[1,2,3,4,5]
After making the fistula, we carried out another electrocochleography exam and the ears were randomly assigned to two study groups: fistula maintenance or its immediate closure (Closed Fistula Group - CF) with fat tissue, which fragments were obtained through the same skin incision and carefully placed on the round window
Of the forty guinea pigs with which we started the study, 10 were taken off because they died in the immediate post-op, or for having developed acute otitis media or secretory otitis media seen during the inspection of the mastoid bulla at the time of the third electrocochleography (PFT)
Summary
Considered as an abnormal shunt between the cochlea and the middle ear cavity, the perilymphatic fistula (PF) can be the result of chronic otitis media complications, head injury, acoustic trauma and barotrauma, amongst others, and we must stress the fistulas caused by congenital malformations responsible for repetition meningitis spells, the iatrogenic ones and the ones related to ear surgery, especial stapes surgeries[1,2,3,4,5].There are reports of a great clinical expression variability, which makes it difficult, the diagnosis, but it impairs the attempts to classify or standardize its signs and symptoms. There is evidence that normalizing the perilymphatic pressure is needed in order to recover the membranous labyrinth and bring about early improvement to the vestibular systems[9,10,11,12]. Such fact can not be ignored, since it is based on a viable treatment option that must be made available for the patients, especially when considering the poor results obtained from the treatment of sensorineural hearing loss in general
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