Utility of vestibular testing and new technologies in a complex cholesteatoma

Abstract

This paper reports a patient with a large recidivist cholesteatoma who underwent audio-vestibu-lar tests and used customized 3D technologies (3D printing, augmented reality, virtual reality) to understand risks of the surgery. The patient was extremely concerned with her clinical findings and it found difficult to understand them. Customized 3D models helped the patient to understand the spatial relations and possible complications of surgery. The benefits of using new technologies in preoperative surgical planning for the surgeon and patient are also explained in a setting when radiological findings indicate high risks for surgery. Computed tomography scan showed a posterior semicircular canal fistula, which would add a significant challenge to the surgery. The fistula was not found in the result of the physiological test (cervical vestibular evoked myogenic potentials) and not found intra-operatively. Application of modern audio-vestibular investigations and use of customized 3D technologies may prove useful aids.