The influence of the mastoid air cell system buffer function on the appearance of a spontaneous perilymphatic fistula development.

Objective: Aim: To examine mastoid pneumatisation in patients with perilymphatic fistula (PLF) and determine the influence of its buffering function on the onset and prognosis of the disease.

Patients and methods: Materials and Methods: The study included 37 patients with PLF and labyrinthine window ruptures, experiencing unilateral hearing loss on the affected side. Mastoid process length, the volume of the mastoid, the planimetric size of the mastoid, and the area of the mastoid air-containing cells were measured. The assessment was made by temporal bone computed tomography.

Results: Results: Thirty-two patients had signs of impaired ventilation of the middle ear and mastoid due to Eustachian tube (ET) dysfunction. The length of the mastoid process and its planimetric size in patients with hypopneumatized mastoids were significantly lower than in patients with non-hypopneumatized mastoids (which included 4 cases of normal pneumatisation and 1 case of hyperpneumatised mastoid process). The area of air-containing cells of the mastoid, its volume, and the average length were significantly lower when compared to the corresponding indicators on the conditionally healthy ear side. The obtained data may indicate a disruption of the protective buffering function on the affected ear side and can be considered as one of the possible causes of PLF with labyrinthine window ruptures.

Conclusion: Conclusions: Thus, when mastoid pneumatisation decreases, its buffering function is compromised, posing a risk of damage to the middle and inner ear with the potential occurrence of PLF and labyrinthine window ruptures. The effectiveness of treatment for these patients depends on a comprehensive approach.