---
title: "Labyrinthine Fistula"
description: "ENT notes on Labyrinthine Fistula - Causes, Pathology, Clinical Features, Investigations and Treatment."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/labyrinthine-fistula"
categories: ["Otology"]
video: "https://www.youtube.com/watch?v=RreFLC_cXwo"
image: "https://media.theentresident.com/og-images/labyrinthine-fistula.png"
---

# Labyrinthine Fistula

ENT notes on Labyrinthine Fistula - Causes, Pathology, Clinical Features, Investigations and Treatment. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=RreFLC_cXwo

## 🌀 Labyrinthine Fistula - Circumscribed Labyrinthitis

### 📖 What is Labyrinthine Fistula?

Labyrinthine fistula is an **abnormal communication** between the **inner ear (labyrinth)** and the **middle ear**.  

>Which part of labyrinth is involved in labyrinthine fistula?

>What is the most common site for Labyrinthine Fistula?

---

### ⚠️ Causes of Labyrinthine Fistula

- **Most common:** Chronic Suppurative Otitis Media (**CSOM**) with cholesteatoma  

- **Others:**
  - Middle ear neoplasms (carcinoma, glomus tumor)  
  - Surgical or accidental trauma to the labyrinth  

---

### 🩺 Clinical Features of Labyrinthine Fistula

- Many patients remain **asymptomatic**.  

- If symptoms are present:

  - **Brief episodes** of imbalance, disequilibrium, or vertigo  

  - Equilibrium usually normal between episodes  

  - Fistula Test positive

  - Nystagmus

  - Tullio’s Phenomenon

>What is Fistula Test? How do you perform Fistula Test?

>What is Positive Fistula Test?

>What is False positive Fistula test? Name some conditions where you see it.

>What is False negative Fistula test? Name some conditions where you see it.

>What is Hennebert's sign?

>What are the different directions of nystagmus on involvement of different semicircular canals in labyrinthine fistula?

>What is Tullio’s Phenomenon?

---

### 🧪 Investigations of Labyrinthine Fistula

1. **Clinical diagnosis** — confirmed by fistula test  

2. **HRCT Temporal Bone** — best for detecting bony erosion of semicircular canals  

3. **MRI** — only if intracranial complications are suspected  

---

### 💉 Treatment of Labyrinthine Fistula

- **Surgical:**
  - Complete removal of cholesteatoma matrix from fistula site  
  - Mastoid exploration and clearance of disease  

- **Medical:**
  - Systemic antibiotics (before and after surgery) to prevent labyrinthine infection spread

---

## About This Note

This free ENT note on Labyrinthine Fistula was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/labyrinthine-fistula

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Otology: https://www.theentresident.com/ent-notes-lectures/category/otology.md

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