scholarly journals Complete round Window Niche Occlusion for Superior Semicircular Canal Dehiscence Syndrome: A Minimally Invasive Approach

2009 ◽  
Vol 88 (8) ◽  
pp. 1042-1056 ◽  
Author(s):  
Herbert Silverstein ◽  
Mark J. Van Ess
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Surgical Techniques ◽  
Invasive Approach ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Auditory Dysfunction ◽  
Round Window Niche ◽  
Canal Dehiscence

Superior semicircular canal dehiscence (SCD) syndrome is a recognized condition associated with varying degrees of vestibular and auditory dysfunction. The authors present a case study of disabling SCD syndrome in a 37-year-old man who was successfully treated with a complete round window niche occlusion via a transcanal approach. This case represents the first report of a transcanal complete round window niche occlusion for the treatment of SCD syndrome. A brief literature review and discussion of surgical techniques follow.

Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence syndrome

2013 ◽  
Vol 127 (7) ◽  
pp. 705-707 ◽  
Author(s):  
A Nikkar-Esfahani ◽  
D Whelan ◽  
A Banerjee
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Round Window Membrane ◽  
Superior Semicircular Canal Dehiscence ◽  
Tullio Phenomenon ◽  
Superior Semicircular Canal ◽  
Case Surgery ◽  
Post Operation ◽  
Round Window Niche ◽  
Canal Dehiscence

AbstractBackground:Conductive hyperacusis in superior semicircular canal dehiscence syndrome occurs due to the presence of a ‘third window’ created by the dehiscence. Reversible blocking of the round window can, in theory, cause a reduction in the compression-related volume displacement, and thereby minimise symptoms of conductive hyperacusis. This study describes a technique of permeatal blocking of the round window.Method:The tympanomeatal flap is elevated and the round window niche is identified. The round window membrane is subsequently identified and occluded with bone wax, muscle and fascia, in three separate layers. Finally, the tympanomeatal flap is reflected, and an ear wick is inserted.Results:Two patients who underwent the procedure reported a reduction in symptoms. Importantly, no Tullio phenomenon was reported post-operation.Conclusion:Blocking of the round window can be used to control symptoms of superior semicircular canal dehiscence syndrome in patients who present solely with symptoms of conductive hyperacusis. This technique provides an alternative to resurfacing techniques. The procedure is simple to perform, reversible and can be undertaken as day-case surgery.

Superior semicircular canal dehiscence syndrome

2017 ◽  
Vol 127 (6) ◽  
pp. 1268-1276 ◽  
Author(s):  
Wenya Linda Bi ◽  
Ryan Brewster ◽  
Dennis Poe ◽  
David Vernick ◽  
Daniel J. Lee ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Surgical Repair ◽  
Round Window ◽  
Bony Defect ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Superior Petrosal Sinus ◽  
Adults And Children ◽  
Surgical Options ◽  
Canal Dehiscence

Superior semicircular canal dehiscence (SSCD) syndrome is an increasingly recognized cause of vestibular and/or auditory symptoms in both adults and children. These symptoms are believed to result from the presence of a pathological mobile “third window” into the labyrinth due to deficiency in the osseous shell, leading to inadvertent hydroacoustic transmissions through the cochlea and labyrinth. The most common bony defect of the superior canal is found over the arcuate eminence, with rare cases involving the posteromedial limb of the superior canal associated with the superior petrosal sinus. Operative intervention is indicated for intractable or debilitating symptoms that persist despite conservative management and vestibular sedation. Surgical repair can be accomplished by reconstruction or plugging of the bony defect or reinforcement of the round window through a variety of operative approaches. The authors review the etiology, pathophysiology, presentation, diagnosis, surgical options, and outcomes in the treatment of this entity, with a focus on potential pitfalls that may be encountered during clinical management.

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

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.

scholarly journals The Supine Superior Semicircular Canal Dehiscence Test

2021 ◽  
pp. 1-6
Author(s):  
Carrie W. Hoppes ◽  
Karen H. Lambert ◽  
Chris Zalewski ◽  
Robin Pinto ◽  
Holly Burrows ◽  
...  
Keyword(s):  
Dura Mater ◽  
Semicircular Canal ◽  
False Negative ◽  
New Method ◽  
Superior Semicircular Canal Dehiscence ◽  
Bony Labyrinth ◽  
Superior Semicircular Canal ◽  
Potential Benefits ◽  
Canal Dehiscence

Purpose The purpose of this clinical focus article is to describe a new method for assessment of superior semicircular canal dehiscence by laying the patient supine during Valsalva-induced nystagmus testing. Method The traditional Valsalva-induced nystagmus test is described, followed by a new method for assessment of superior semicircular dehiscence conducted by laying the patient supine during testing. A case study is presented to illustrate this new testing technique known as the Supine Superior Semicircular Canal Dehiscence Test. Results It is hypothesized that during Valsalva-induced nystagmus testing performed in the upright, seated position, the dura mater could potentially seal the superior semicircular canal fistula, thereby concealing a defect in the bony labyrinth and yielding a false-negative test. To circumvent this, the patient should be placed in the supine position during Valsalva-induced nystagmus testing in order to prevent the dura mater from inadvertently sealing itself against the petrous portion of the temporal bone. The Supine Superior Semicircular Canal Dehiscence Test may reveal the defect in the bony labyrinth and improve the sensitivity of the Valsalva-induced nystagmus test. Conclusions The Supine Superior Semicircular Canal Dehiscence Test may be more sensitive for identifying superior semicircular canal dehiscence in patients with traditional symptoms and a negative Valsalva-induced nystagmus test in the seated position. While a case study is presented to illustrate the potential benefits of including the Supine Superior Semicircular Canal Dehiscence Test in the battery of diagnostic tests, further research is needed in larger samples.

Round window plugging in the treatment of superior semicircular canal dehiscence

2017 ◽  
Vol 128 (6) ◽  
pp. 1445-1452 ◽  
Author(s):  
Eric F. Succar ◽  
Periakaruppan V. Manickam ◽  
Sara Wing ◽  
Jeffrey Walter ◽  
Joseph S. Greene ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

Round window reinforcement for superior semicircular canal dehiscence: A retrospective multi-center case series

2014 ◽  
Vol 35 (3) ◽  
pp. 286-293 ◽  
Author(s):  
Herbert Silverstein ◽  
Jack M. Kartush ◽  
Lorne S. Parnes ◽  
Dennis S. Poe ◽  
Seilesh C. Babu ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Case Series ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

scholarly journals Superior Semicircular Canal Dehiscence Syndrome – Diagnosis and Surgical Management

2017 ◽  
Vol 21 (02) ◽  
pp. 195-198 ◽  
Author(s):  
Marite Palma Diaz ◽  
Juan Cisneros Lesser ◽  
Alfredo Vega Alarcón
Keyword(s):  
Hearing Loss ◽  
Semicircular Canal ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Success Rates ◽  
Superior Semicircular Canal Dehiscence ◽  
Middle Fossa Approach ◽  
Advantages And Disadvantages ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

Introduction Superior semicircular canal dehiscence syndrome was described by Minor et al in 1998. It is a troublesome syndrome that results in vertigo and oscillopsia induced by loud sounds or changes in the pressure of the external auditory canal or middle ear. Patients may present with autophony, hyperacusis, pulsatile tinnitus and hearing loss. When symptoms are mild, they are usually managed conservatively, but surgical intervention may be needed for patients with debilitating symptoms. Objective The aim of this manuscript is to review the different surgical techniques used to repair the superior semicircular canal dehiscence. Data Sources PubMed and Ovid-SP databases. Data Synthesis The different approaches are described and discussed, as well as their limitations. We also review the advantages and disadvantages of the plugging, capping and resurfacing techniques to repair the dehiscence. Conclusions Each of the surgical approaches has advantages and disadvantages. The middle fossa approach gives a better view of the dehiscence, but comes with a higher morbidity than the transmastoid approach. Endoscopic assistance may be advantageous during the middle cranial fossa approach for better visualization. The plugging and capping techniques are associated with higher success rates than resurfacing, with no added risk of hearing loss.

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