Round window fistula

Abstract

A72-year-old woman was referred for a tympanic-mastoid cholesteatoma with erosion of the tegmen and right-sided complete deafness. Otoscopic examination showed near-complete atelectasis with a small tubal region perforation, scutum and facial canal erosion, absence of ossicles, and enlargement of the round window niche (Fig 1). The patient underwent canal-wall-down mastoidectomy under general anesthesia after providing written informed consent. Erosion of the round window promontory with endosteum sparing was observed after matrix removal (Fig 2). Temporalis fascia was used to protect the inner ear and facial nerve. Squama periosteum was used to obliterate the tubal orifice; bone dust was used to repair the tegmen tympani. The patient was discharged on the first postoperative day. She is well and free of disease 15 months later.