Automastoidectomy with labyrinthine fistula

Case contributed by Dr Mohamed Saber

Presentation

Chronic right ear discharge with newly developed tinnitus and dizziness. No history of previous surgical operations.

Patient Data

Age: 45 years
Gender: Female

Loss of right middle ear ossicular chain, as well as bony septae of mastoid air cells with subsequent formation of one cavity, shows internal soft tissue densities. Focal erosion of the bony wall of the right lateral semicircular canal.

Annotated image

The red arrow points to the erosion of the bony wall of the right lateral semicircular canal. The green arrow points to the normal left side for comparison.

Case Discussion

Automastoidectomy refers to extensive bony destruction of the mastoid forming one cavity resembling operative mastoidectomy. Cholesteatoma is the most common cause and this subtype is known as "mural cholesteatoma".

Labyrinthine fistula refers to abnormal communication between inner ear perilymph and middle ear cavity on top of erosion or fracture of the bony labyrinth.

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