Introduction: Labyrinthine fistula is an uncommon complication of chronic otitis media with cholesteatoma. Surgical
management of labyrinthine fistula is challenging due to high risk of worsening labyrinthine function post-operatively.
Case report: We report a case of a 25-year old female presented with one-week history vertigo, vomiting and fever with
left intermittent otorrhea for the past one year. High resolution computed tomography (HRCT) of the temporal bone
showed total opacification of left mastoid cavity and dehiscence of left lateral semicircular canal (LSCC). Left Modified
Radical Mastoidectomy (MRM) was performed and cholesteatoma was found within mastoid and middle ear cavities with
dehiscence of arch of left LSCC wall with no perilymph leak observed.
Conclusion: The presence of vertigo with or without sensorineural hearing loss in patients with chronically discharging
ear must raise suspicion of labyrinthine fistula. Definitive diagnosis can only be made intraoperatively. The current
recommendation on management is open surgery with removal of cholesteatoma and sealing of fistula using soft tissue
graft which provides favourable outcome.