Presentation
Chronic right ear discharge, pain with diminished hearing. Previous history of surgical intervention.
Patient Data
Signs of previous operative changes (mastoidectomy) are noted. Thickened retracted and likely perforated tympanic membrane. Pathological soft tissues are noted within the presumed surgical bowel and extending to the middle ear cleft along the epitympanum, superior wall and promontory abutting the oval window niche. Small high density of bone attenuation is noted at the middle ear cleft likely representing an ossicular remnant. Eroded lateral wall of the lateral semicircular canal communicating with the previously described middle ear pathology. Rarefied tegmen tympani however still intact. Cloudy visualised mastoid air cells with thickened trabeculae.
Case Discussion
Labyrinthine fistula also known as perilymphatic fistula which is abnormal communication between the inner ear perilymph and the middle ear cavity other than round and oval windows.
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