Preservation of cochlear function in the surgery of cholesteatomatous labyrinthine fistulas and oval window tympanosclerosis.

Anakusis is reported as a not uncommon complication of the surgical treatment of cholesteatomatous fistula of the labyrinth. Likewise, although published results on the surgical treatment of tympanosclerotic ears are infrequent, most otologists are aware of greater than usual risks of severe sensorineural impairment from ossiculoplasty in this type of middle ear disease. Because of recent developments in implanted aids-to-hearing, in tympanoplasty operations, when they fail to adequately improve hearing, preservation of eighth nerve function becomes ever-increasingly important. This article concerns two types of middle ear disease in which surgical treatment threatens hair cells and neurons, to the extent that surgical complications might prejudice the eventual possible benefits of a standard hearing aid or any implanted device, if either was indicated.