0:01

This case is instructive because it shows us some of

0:04

the inner ear pathology in a patient who has been

0:08

previously operated. So, as you can clearly see,

0:11

the patient has had a mastoidectomy on the right

0:15

side and the posterior wall of the external

0:20

auditory canal is intact.

0:23

And so, we would call this canal wall-up mastoidectomy.

0:28

And why did they do this?

0:29

And what we can see is, if we follow the surgical

0:34

structures, here is a wire which is entering

0:41

the cochlea as a cochlear implant.

0:45

So this patient has a cochlear implant on the right

0:49

side after a canal wall-up mastoidectomy.

0:52

Now, one of the phenomena that I'd like to point out

0:55

in this case is the presence of air within the

1:02

vestibule. And not only is it within the vestibule,

1:05

but you can see air within the lateral

1:07

semicircular canal identified here.

1:11

So this is a patient who has effectively Barotrauma,

1:15

that is air communicating with the vestibule

1:20

and lateral semicircular canal.

1:22

And this is a potential source of inflammation

1:26

of the labyrinth and one of the causes of labyrinthitis.

1:31

So this is a post-op case of communication of air in

1:36

the vestibule and lateral semicircular canal in a

1:40

case of Barotrauma leading to labyrinthitis.

1:45

Now, as far as the source or the reason

1:49

for the cochlear implant,

1:51

we'll get to that etiology with some of our

1:53

discussion of otospongiosis as one of the more

1:56

common of the causes of hearing loss that require

2:00

that benefits from cochlear implantation.

Labyrinthine Fistula Mastoidectomy and Cochlea implant

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