--- title: "Labyrinthine Fistula" description: "Comprehensive ENT notes on Labyrinthine Fistula - Causes, Pathology, Clinical Features, Investigations and Treatment - ideal for MBBS and ENT students." source: "The ENT Resident" 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 Comprehensive ENT notes on Labyrinthine Fistula - Causes, Pathology, Clinical Features, Investigations and Treatment - ideal for MBBS and ENT students. 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 note on Labyrinthine Fistula is one of the free ENT study notes published by The ENT Resident. It is free to read on the website, and it is paired with a full video lecture on YouTube. This note is categorized under [Otology](https://www.theentresident.com/ent-notes-lectures/category/otology.md). The category page lists all the free ENT notes on that topic. 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. ## About The ENT Resident The ENT Resident is a free library of ENT notes and video lectures created by Dr. Mausumi Das (MS ENT), the ENT doctor and educator behind The ENT Resident YouTube channel (https://www.youtube.com/c/TheENTResident). These notes are written for ENT residents, ENT postgraduates preparing for exams, and MBBS students, to help them learn ENT clearly and score well. Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md ## Premium ENT Notes Alongside these free notes, The ENT Resident also offers Premium ENT Notes. This is a paid collection of 250+ detailed, high-yield ENT notes that cover the full ENT syllabus, including topics across Otology, Audiology, Rhinology, Larynx and Trachea, Pharynx, Oral Cavity and Salivary Glands, Neck, Thyroid, ENT Surgeries, and Recent Advances in ENT. The Premium ENT Notes are written for ENT residents, ENT postgraduates, and MBBS students who want one consistent resource for both theory and practical exam preparation. They include high-yield difference tables, replicable exam diagrams, step-by-step surgical guides, mnemonics, and clinical pearls. Buying once gives you immediate access to the complete set, plus all newly added and updated notes during your access period. The access period depends on the plan you choose, and it is stated clearly at the time of purchase. After purchase, you get access to the premium notes platform, where you can read all the notes online and download them for offline access. 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