Sealing of superior semicircular canal dehiscence is associated with improved balance outcomes postoperatively versus plugging of the canal in middle fossa craniotomy repairs: a case series

2020 ◽  
Vol 133 (2) ◽  
pp. 462-466
Author(s):  
Vivian Wung ◽  
Prasanth Romiyo ◽  
Edwin Ng ◽  
Courtney Duong ◽  
Thien Nguyen ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Chart Review ◽  
Case Series ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Postoperative Mri ◽  
Mri Scans ◽  
Postoperative Symptoms ◽  
Fluid Signal ◽  
Canal Dehiscence

OBJECTIVEThe authors compared postoperative symptoms between patients with sealed and those with plugged semicircular canal dehiscence repairs.METHODSIn total, 136 ears from 118 patients who underwent surgical repair for semicircular canal dehiscence were identified via chart review. Data from postoperative MRI scans showing preservation or loss of semicircular canal fluid signal and postoperative reports of autophony, amplification, aural fullness, tinnitus, hyperacusis, hearing loss, vertigo, dizziness, disequilibrium, oscillopsia, and headache were amalgamated and analyzed.RESULTSPatients with preservation of fluid signal were far less likely to have dizziness postoperatively (p = 0.007, OR 0.158, 95% CI 0.041–0.611). In addition, these patients were more likely to have tinnitus postoperatively (p = 0.028, OR 3.515, 95% CI 1.145–10.787).CONCLUSIONSThe authors found that superior semicircular canal dehiscence patients who undergo sealing without plugging have improved balance outcomes but show more tinnitus postoperatively than patients who undergo plugging.

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

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

Superior semicircular canal dehiscence postoperative outcomes: A case series of 156 repairs

2019 ◽  
Vol 68 ◽  
pp. 69-72 ◽  
Author(s):  
Prasanth Romiyo ◽  
Courtney Duong ◽  
Edwin Ng ◽  
Vivian Wung ◽  
Methma Udawatta ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Case Series ◽  
Postoperative Outcomes ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

scholarly journals Pediatric superior semicircular canal dehiscence: illustrative case and systematic review

2017 ◽  
Vol 20 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Carlito Lagman ◽  
Vera Ong ◽  
Lawrance K. Chung ◽  
Lekaa Elhajjmoussa ◽  
Christina Fong ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Semicircular Canal ◽  
Case Series ◽  
Signs And Symptoms ◽  
Illustrative Case ◽  
Search Term ◽  
Female Ratio ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

OBJECTIVEThe purpose of this study is to present an illustrative case of pediatric superior semicircular canal dehiscence (SSCD) and to systematically review the current published literature in the pediatric population.METHODSAn electronic search of the Scopus, Web of Science, PsycINFO, Cochrane, and Embase databases was performed by 2 independent authors through January 2017. Search term combinations included “pediatrics,” “children,” “canal,” and “dehiscence.” Inclusion criteria were as follows: English, full-text clinical studies, case reports, and case series describing pediatric patient(s) (younger than 18 years) with CT evidence of SSCD. Baseline patient demographic characteristics, clinical presentations, dehiscence characteristics, management strategies, and outcome data were extracted.RESULTSA total of 14 studies involving 122 patients were included in the quantitative synthesis. The patients’ mean age was 7.22 years. Male predominance was observed (approximate male-to-female ratio of 1.65:1). Neurodevelopmental disorders were common (n = 14, 11.5%). Auditory signs and symptoms were more common than vestibular signs and symptoms. Hearing loss (n = 62, 50.8%) was the most common auditory symptom and an indicator for imaging evaluation. Vertigo was the most common vestibular symptom (n = 8, 6.6%). Hearing aids were recommended in 8 cases (6.6%), and surgical repair was performed in 1 case (0.8%). Symptom outcomes and follow-up durations were infrequently reported.CONCLUSIONSThe authors’ data suggest that in pediatric SSCD, males are more commonly affected than females. This is different than the adult population in which females are predominantly affected. A history of otologic and/or neurodevelopmental abnormalities was common. There was a preponderance of auditory symptoms in this age group. Conservative management was favored in the majority.

Recent advances in superior semicircular canal dehiscence syndrome

2015 ◽  
Vol 129 (3) ◽  
pp. 217-225 ◽  
Author(s):  
G Chilvers ◽  
I McKay-Davies
Keyword(s):  
Semicircular Canal ◽  
Health Management ◽  
Case Reports ◽  
False Positive Rate ◽  
Case Series ◽  
Vestibular Evoked Myogenic Potential ◽  
Retrospective Case ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Canal Dehiscence

AbstractObjective:This study aimed to review the current advances in superior semicircular canal dehiscence syndrome and to ascertain its aetiology, whether dehiscence size correlates with symptoms, signs and investigation results, the best investigations, and its surgical management.Methods:A literature search using the key words ‘superior semicircular canal dehiscence’ was performed using the Allied and Complementary Medicine Database and the Embase, Health Management Information Consortium, Medline, PsycINFO, British Nursing Index, Cinahl and Health Business Elite databases for the period January 2009 to May 2014. Systematic reviews, meta-analyses, randomised controlled trials, prospective and retrospective case series, case reports, and observational studies were included.Results:Of the 205 papers identified, 35 were considered relevant.Conclusion:The aetiology of superior semicircular canal dehiscence syndrome is unclear. Dehiscence size significantly affects the air–bone gap and ocular vestibular evoked myogenic potential thresholds. Computed tomography evaluation has a high false positive rate. The middle cranial fossa approach is the surgical standard for treating this syndrome; however, the transmastoid approach is gaining popularity.

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

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.

Peripheral Vestibular Disorders in Children and Adolescents with Concussion

2018 ◽  
Vol 159 (2) ◽  
pp. 365-370 ◽  
Author(s):  
Jacob R. Brodsky ◽  
Talia N. Shoshany ◽  
Sophie Lipson ◽  
Guangwei Zhou
Keyword(s):  
Semicircular Canal ◽  
Pediatric Patients ◽  
Case Series ◽  
Vestibular Disorders ◽  
Temporal Bone Fracture ◽  
Perilymphatic Fistula ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Benign Paroxysmal Positioning Vertigo ◽  
Canal Dehiscence

Objective To review peripheral vestibular disorders in pediatric patients with dizziness following concussion. Study Design Case series with chart review. Setting Pediatric vestibular clinic and pediatric multidisciplinary concussion clinic at a tertiary level pediatric hospital. Subjects and Methods We retrospectively reviewed 109 patients seen for dizziness following a concussion between September 2012 and July 2015. Patients were ≤20 years of age at the time of concussion. Incidences of specific peripheral vestibular disorders were assessed along with timing of diagnosis relative to the date of injury, diagnostic test findings, and treatment interventions associated with those diagnoses. Results Twenty-eight patients (25.7%) were diagnosed with peripheral vestibular disorders. None of these disorders were diagnosed prior to evaluation in our pediatric vestibular clinic or our multidisciplinary concussion clinic, which occurred a mean of 133 days (95% confidence interval, 89.2-177.3) after injury. Benign paroxysmal positioning vertigo was diagnosed in 19 patients, all of whom underwent successful canalith repositioning maneuvers. Other diagnoses included temporal bone fracture (n = 3), labyrinthine concussion (n = 2), perilymphatic fistula (n = 2), and superior semicircular canal dehiscence (n = 2). Both patients with perilymphatic fistula and 1 patient with superior semicircular canal dehiscence underwent successful surgical management, while 1 patient with superior semicircular canal dehiscence was managed nonsurgically. Conclusion Peripheral vestibular disorders may occur in pediatric patients with dizziness following concussion, but these disorders may not be recognized until symptoms have persisted for several weeks. An algorithm is proposed to guide the diagnosis and management of peripheral vestibular disorders in pediatric patients with concussion.

Cervical and Ocular VEMP Testing in Diagnosing Superior Semicircular Canal Dehiscence

2017 ◽  
Vol 156 (5) ◽  
pp. 917-923 ◽  
Author(s):  
Jacob B. Hunter ◽  
Neil S. Patel ◽  
Brendan P. O’Connell ◽  
Matthew L. Carlson ◽  
Neil T. Shepard ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Semicircular Canal ◽  
Case Series ◽  
Roc Curves ◽  
Vestibular Evoked Myogenic Potentials ◽  
Hearing Level ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Ocular Vemp ◽  
Canal Dehiscence

Objective To determine the sensitivity and specificity of ocular and cervical vestibular evoked myogenic potentials (VEMPs) in the diagnosis of superior semicircular canal dehiscence (SCD) and to describe the VEMP response characteristics that are most sensitive to SCD and compare the findings to previous reports. Study Design Case series with chart review. Setting Two tertiary neurotologic referral centers. Subjects and Methods Cervical and ocular VEMP peak-to-peak amplitudes and thresholds from 39 adult patients older than 18 years with surgically confirmed SCD were compared with 84 age-matched controls. Results Using receiver operating characteristic (ROC) curves, cervical VEMP (cVEMP) amplitudes, cVEMP thresholds, and ocular VEMP (oVEMP) amplitudes had areas under the curve of 0.731, 0.912, and 0.856, respectively, all of which were statistically significant ( P < .0001). For cVEMP thresholds, at the clinical equivalent ≤85-dB normalized hearing level (nHL) threshold, the sensitivity and specificity were 97.3% and 31.3%, respectively. At the ≤70-dB nHL threshold, the sensitivity and specificity were 73.0% and 94.0%, respectively. For oVEMP amplitudes >12.0 µV, the sensitivity and specificity were 78.6% and 81.7%, respectively. Conclusion Data from this multicenter study suggest that both cVEMP thresholds and oVEMP amplitudes remain good diagnostic tests for identifying SCD, with each test dependent on a number of factors. The sensitivity and specificity of these individual tests may vary slightly between centers depending on testing parameters used.

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