Key points:
  1. We report labyrinthine fistulas in 15% of middle ear cholesteatomas that underwent mastoidectomies.
  2. We observe that preoperative HCRT had 93% sensitivity and 95% specificity in the identification of LFs.
  3. Intraoperative findings include erosion of 79% stapes, 93% incus, 79% malleus and dehiscence in 29% tegmen tympani and 64% tympanic facial canal.
  4. Significantly higher incidence of stapes erosion and tegmen dehiscence observed in cholesteatomas with labyrinthine fistulas compared to without.
  5. 6 out of 8 patients with complete matrix removal and fistula repair did not have a change in hearing. Hence it is possible to preserve hearing with complete matrix removal.