A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence

Abstract Objectives Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% (n = 62) of cases were male, and 51.2% (n = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI.

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Superior semicircular canal dehiscence with a large tegmental defect

The Journal of Laryngology & Otology ◽

10.1017/s0022215106004178 ◽

2006 ◽

Vol 121 (2) ◽

pp. 189-191 ◽

Cited By ~ 18

Author(s):

S Mahendran ◽

V S Sunkaraneni ◽

D M Baguley ◽

P R Axon

Keyword(s):

Semicircular Canal ◽

Previous History ◽

Clinical Manifestations ◽

Large Defect ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

Tegmen Tympani ◽

History Of ◽

Canal Dehiscence

We report on the presentation and clinical manifestations of superior semicircular canal dehiscence in association with a large defect of the tegmen tympani in a 41-year-old woman with no previous history of trauma. Based on this case we recommend that clinicians consider the possibility of superior semicircular canal dehiscence in patients presenting with symptoms associated with tegmen defects.

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Case Report: Local Anesthesia Round Window Plugging and Simultaneous Vibrant Soundbridge Implant for Superior Semicircular Canal Dehiscence

Frontiers in Neurology ◽

10.3389/fneur.2020.581783 ◽

2020 ◽

Vol 11 ◽

Author(s):

Giulia Mignacco ◽

Lorenzo Salerni ◽

Ilaria Bindi ◽

Giovanni Monciatti ◽

Alfonso Cerase ◽

...

Keyword(s):

Semicircular Canal ◽

Round Window ◽

Bone Conduction ◽

Hearing Threshold ◽

Vestibular Evoked Myogenic Potentials ◽

Vibrant Soundbridge ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

The Right ◽

Canal Dehiscence

The aim of the present study is to report the outcomes of round window reinforcement surgery performed with the application of a Vibrant Soundbridge middle ear implant (VSB; MED-EL) in a patient with superior semicircular canal dehiscence (SSCD) who presented with recurrent vertigo, Tullio phenomenon, Hennebert's sign, bone conduction hypersensitivity, and bilateral moderate to severe mixed hearing loss. Vestibular evoked myogenic potentials (VEMPs) and high-resolution computed tomography (HRCT) confirmed bilateral superior semicircular canal dehiscence while this was not seen in magnetic resonance imaging. The surgical procedure was performed in the right ear as it had worse vestibular and auditory symptoms, a poorer hearing threshold, and greatly altered HRCT and VEMPs findings. With local-assisted anesthesia, round window reinforcement surgery (plugging) with perichondrium was performed with simultaneous positioning of a VSB on the round window niche. At the one and 3 months follow-up after surgery, VSB-aided hearing threshold in the right ear improved to mild, and loud sounds did not elicit either dizziness or pain in the patient.

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Ontogenetic Explanation for Tegmen Tympani Dehiscence and Superior Semicircular Canal Dehiscence Association

Acta Otorrinolaringologica (English Edition) ◽

10.1016/j.otoeng.2016.07.001 ◽

2016 ◽

Vol 67 (4) ◽

pp. 226-232 ◽

Cited By ~ 1

Author(s):

Jesús José Fraile Rodrigo ◽

Ana I. Cisneros ◽

Jesús Obón ◽

Carmen Yus ◽

Rafael Crovetto ◽

...

Keyword(s):

Semicircular Canal ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

Tegmen Tympani ◽

Canal Dehiscence

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Head rotation evoked tinnitus due to superior semicircular canal dehiscence

The Journal of Laryngology & Otology ◽

10.1017/s0022215109991241 ◽

2009 ◽

Vol 124 (3) ◽

pp. 333-335 ◽

Cited By ~ 9

Author(s):

E-C Nam ◽

R Lewis ◽

H H Nakajima ◽

S N Merchant ◽

R A Levine

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Semicircular Canal ◽

Head Rotation ◽

Bony Defect ◽

Case Presentation ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

The Right ◽

Canal Dehiscence

AbstractIntroduction:Superior semicircular canal dehiscence affects the auditory and vestibular systems due to a partial defect in the canal's bony wall. In most cases, sound- and pressure-induced vertigo are present, and are sometimes accompanied by pulse-synchronous tinnitus.Case presentation:We describe a 50-year-old man with superior semicircular canal dehiscence whose only complaints were head rotation induced tinnitus and autophony. Head rotation in the plane of the right semicircular canal with an angular velocity exceeding 600°/second repeatedly induced a ‘cricket’ sound in the patient's right ear. High resolution temporal bone computed tomography changes, and an elevated umbo velocity, supported the diagnosis of superior semicircular canal dehiscence.Conclusion:In addition to pulse-synchronous or continuous tinnitus, head rotation induced tinnitus can be the only presenting symptom of superior semicircular canal dehiscence without vestibular complaints. We suggest that, in our patient, the bony defect of the superior semicircular canal (‘third window’) might have enhanced the flow of inner ear fluid, possibly producing tinnitus.

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Eye Movement Autophony: A Unique Presenting Symptom of Semicircular Canal Dehiscence Syndrome

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v35i1.1301 ◽

2020 ◽

Vol 35 (1) ◽

pp. 74-75

Author(s):

Nathaniel Yang

Keyword(s):

Eye Movements ◽

Eye Movement ◽

Semicircular Canal ◽

Imaging Study ◽

Psychiatric Evaluation ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

Number Of Patients ◽

Magnetic Resonance Imaging Mri ◽

Canal Dehiscence

A 31-year-old woman presented with the very unusual symptom of being able to hear the movement of her eyeballs in her left ear: “I can hear my eyeballs move!” She initially described hearing a recurrent “swishing” sound that would occur intermittently. She eventually realized that its occurrence coincided with eyeball movement. In the eight months’ duration of her symptom, she had been unable to obtain a diagnosis from physicians whom she consulted and had even been referred for psychiatric evaluation and treatment. An otolaryngologist whom she consulted had a standard pure tone audiometric examination done, and this showed normal hearing acuity in both ears. A Magnetic Resonance Imaging (MRI) of the inner ear and brain likewise showed no abnormalities. Due to the peculiarity of the patient’s complaint, the otolaryngologist consulted with a neurotologist who suspected the presence of a semicircular canal dehiscence. A computerized tomographic imaging study of the temporal bone confirmed the presence of a left superior semicircular canal dehiscence syndrome. (Figures 1 & 2) First described by Minor et al. in 1998, superior semicircular canal dehiscence syndrome is a neurotologic condition that characteristically presents as vertigo, oscillopsia, and/or disequilibrium induced by sound or changes in middle ear or intracranial pressure.1 Subsequent clinical studies described the presence of audiologic symptoms, the most prominent of which were conductive hearing loss and autophony with or without vestibular manifestations.2 Patients described an increased sensitivity to internally generated bone-conducted sounds, such as the heartbeat, chewing, footsteps hitting the ground and eye movements. It is of particular interest that the ability to hear one’s own eye movements, a condition known as eye movement autophony, currently appears to have been described as a symptom only in patients with semicircular canal dehiscence syndrome.3 Anecdotally, although the author of this report has diagnosed quite a number of patients with semicircular canal dehiscence syndrome manifesting primarily with vestibular symptoms, this particular case is the only one that presented with eye movement autophony as the primary and only symptom. Although the patient was not physically incapacitated by vertigo or chronic disequilibrium, she was significantly bothered by the unrelenting nature of her particular symptom. She subsequently underwent a transmastoid plugging of the superior semicircular canal which completely relieved her of the symptom.

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Dural Contact to the Malleus Head in Patients with Superior Semicircular Canal Dehiscence (SSCD): Case Series and Review of SSCD and Tegmen Defects

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211007257 ◽

2021 ◽

pp. 000348942110072

Author(s):

Carissa Wentland ◽

Joseph Cousins ◽

Jason May ◽

Arnaldo Rivera

Keyword(s):

Semicircular Canal ◽

Tertiary Care ◽

Case Series ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

Tegmen Tympani ◽

Limited Series ◽

Tertiary Care Institution ◽

The Mean ◽

Canal Dehiscence

Objective: Report a series of cases in which patients have concomitant superior semicircular canal dehiscence (SSCD) and a dehiscent tegmen tympani with Dural contact to the malleus head (DCMH). Methods: An analysis of radiologic and audiologic data in 4 patients who presented with SSCD and DCMH at a tertiary care institution. A pertinent literature review was performed. Results: Four patients (5 ears) had SSCD and DCMH. In 3 patients with unilateral DCMH, the mean maximum air-bone gap was 15 dB in the ear with DCMH compared to 50 dB in the ear without DCMH. Of the 5 ears with DCMH, the mean air conduction threshold at 250 Hz was 17 dB compared to 42 dB in the 3 ears without DCMH. Conclusions: We report the findings of DCMH in a series of 4 patients with bilateral SSCD. This limited series suggests that ears with SSCD and DCMH have less of an air-bone gap than would be expected, as 1 would expect an additive effect of DCMH and SSCD on the air-bone gap.

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Superior semicircular canal dehiscence syndrome: a new aetiology

The Journal of Laryngology & Otology ◽

10.1017/s0022215108001965 ◽

2008 ◽

Vol 122 (7) ◽

pp. 741-744 ◽

Cited By ~ 14

Author(s):

P Puwanarajah ◽

P Pretorius ◽

I Bottrill

Keyword(s):

Semicircular Canal ◽

Semicircular Canals ◽

Developmental Venous Anomaly ◽

Venous Anomaly ◽

Superior Semicircular Canal Dehiscence ◽

Tullio Phenomenon ◽

Superior Semicircular Canal ◽

Superior Petrosal Sinus ◽

The Right ◽

Canal Dehiscence

AbstractObjective:We report what we believe to be a unique aetiology of the superior semicircular canal dehiscence syndrome, a recently described condition in which vestibular imbalance and/or hearing loss results from the loss of continuity of the bone overlying the superior semicircular canals.Case report:A 58-year-old woman presented with autophony in the right ear and momentary imbalance when shouting (Tullio phenomenon). Temporal bone computed tomography revealed a defect of the right superior semicircular canal caused by an enlarged superior petrosal sinus receiving drainage from a large cerebellar developmental venous anomaly.Conclusions:We review superior semicircular canal dehiscence syndrome and its management, and we discuss common aetiologies, contrasting these with the unusual aetiology presented here. We conclude that superior semicircular canal dehiscence syndrome may present with a solely developmental aetiology, despite presenting late in life.

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