Surgical treatment of posterior semicircular canal dehiscence syndrome caused by jugular diverticulum

AbstractObjective:We report a rare case of posterior semicircular canal dehiscence caused by a jugular diverticulum, and we describe its surgical treatment using a dehiscence resurfacing manoeuvre.Method:The clinical findings, surgical procedure and outcomes are presented.Results:A 66-year-old man presented with disequilibrium, sound-induced vertigo, a reduced ocular vestibular evoked myogenic potential threshold, and pressure-induced vertical and torsional nystagmus. Computed tomography revealed a right posterior semicircular canal dehiscence caused by a diverticulum of the jugular bulb. The defect in the posterior semicircular canal was localised and resurfaced with bone paté, temporalis muscle fascia and conchal cartilage, under direct visualisation. Post-operatively, the patient's symptoms disappeared and his ocular vestibular evoked myogenic potential threshold normalised.Conclusion:This case illustrates that posterior semicircular canal dehiscence can be surgically managed by resurfacing the defect site via a transmastoid approach.

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Simultaneous, unilateral plugging of superior and posterior semicircular canal dehiscences to treat debilitating hyperacusis

The Journal of Laryngology & Otology ◽

10.1017/s0022215113003605 ◽

2014 ◽

Vol 128 (2) ◽

pp. 174-178 ◽

Cited By ~ 10

Author(s):

P T Dang ◽

T A Kennedy ◽

S P Gubbels

Keyword(s):

Semicircular Canal ◽

Bone Conduction ◽

Vascular Anatomy ◽

Jugular Bulb ◽

Sigmoid Sinus ◽

Posterior Semicircular Canal ◽

Vestibular Evoked Myogenic Potential ◽

Superior Semicircular Canal Dehiscence ◽

Transmastoid Approach ◽

Canal Dehiscence

AbstractObjective:To describe a case of bilateral superior and posterior semicircular canal dehiscences, and the use of a unilateral transmastoid approach to address both right-sided defects simultaneously.Case report:In a patient with right-sided hyperacusis, bilateral dehiscence of both the superior and the posterior semicircular canals was identified, located adjacent to the common crus, together with a right-sided, anterosuperiorly positioned sigmoid sinus and a high-riding jugular bulb. Results for audiography and cervical vestibular evoked myogenic potential testing were consistent with right-sided semicircular canal dehiscence. At surgery, a right-sided transmastoid approach provided access to plug both defects simultaneously, following posterior mobilisation of the sigmoid sinus. The patient's hyperacusis was completely resolved, with a 10–30 dB improvement in his right ear air conduction hearing, without decrement in bone conduction.Conclusion:In properly selected patients, a transmastoid approach can be used to effectively manage superior semicircular canal dehiscence and posterior semicircular canal dehiscence simultaneously. Pre-operative computed tomography is recommended to evaluate the dehiscence sites and to identify complicating vascular anatomy.

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Comparison of Video Head Impulse Test in the Posterior Semicircular Canal Plane and Cervical Vestibular Evoked Myogenic Potential in Patients With Vestibular Neuritis

Otology & Neurotology ◽

10.1097/mao.0000000000001733 ◽

2018 ◽

Vol 39 (4) ◽

pp. e263-e268 ◽

Cited By ~ 2

Author(s):

Jin Su Park ◽

Chang-Hee Kim ◽

Min-Beom Kim

Keyword(s):

Semicircular Canal ◽

Vestibular Neuritis ◽

Head Impulse Test ◽

Video Head Impulse Test ◽

Posterior Semicircular Canal ◽

Vestibular Evoked Myogenic Potential ◽

Head Impulse ◽

Myogenic Potential

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Superior Semicircular Canal Dehiscence Syndrome: Review of Clinical Manifestations in Adults and Children

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v24i2.675 ◽

2009 ◽

Vol 24 (2) ◽

pp. 6-13

Author(s):

Scheherazade C. Ibrahim ◽

Charlotte M. Chiong ◽

Nathaniel W. Yang

Keyword(s):

Semicircular Canal ◽

Clinical Manifestations ◽

Case Series ◽

Vestibular Evoked Myogenic Potential ◽

Superior Semicircular Canal Dehiscence ◽

Computed Tomographic ◽

Myogenic Potential ◽

Superior Semicircular Canal ◽

Computed Tomographic Scan ◽

Canal Dehiscence

Objective: This report aims to determine the clinical manifestations and management of patients with superior semicircular canal dehiscence syndrome (SSCDS). Methods: Study Design: Case series. Setting: Tertiary hospitals and private clinics Participants: Out of 30 patients with vestibular vertigo or otologic symptom, 14 patients were diagnosed with SSCDS based on high resolution computed tomographic scan (HRCT). The demographic features, incidence of specific signs and symptoms and management of these patients were described, including the audiograms, vestibular evoked myogenic potential (VEMP) responses and ancillary tests. Results: Vertigo was the most common vestibular symptom of SSCDS. Tullio phenomenon was elicited in 50% of patients with confirmed dehiscence on HRCT scan. Low frequency (250 Hz and 500 Hz) air-bone gap was noted in 21.4% of patients. Lowered VEMP responses were also noted in 66.7% of patients with confirmed SSCDS. Severity of symptoms may determine its management. Conclusion: The diagnosis of SSCDS does not conform to a specific clinical presentation or audiologic result thus good clinical correlation is needed in order to raise suspicion of the disease and prompt the clinician to order confirmatory imaging by computed tomographic scan or magnetic resonance imaging. The presence of this syndrome in a proportion of children that is greater than previously reported needs further study as these children may be genetically predisposed to have thinned out superior semicircular canals that eventually become dehisced albeit at an earlier age. Key words: Superior semicircular canal dehiscence, pure tone audiometry, vestibular evoked myogenic potential

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