Key results
Our study reported LFs in 15% (14/90) of middle ear cholesteatomas. The evaluation of cholesteatomas pre-operatively with HRCT yielded a high sensitivity (92.9%) and specificity (94.7%) for LFs. Significantly higher incidence of tegmen tympani dehiscence, stapes erosion were seen in ears with LF. Matrix management method in our centre is based on surgeon preference, considering the approximate fistula size based on preoperative imaging and initial hearing. The two LFs with matrix preservation were done due to Surgeon 2’s suspicion of larger fistulas and both patients hearing thresholds. Significantly better postoperative hearing outcomes was observed in complete matrix removal than matrix preservation in our study.