Superior Semicircular Canal Dehiscence – An Otologic Impersonator
DOI:
https://doi.org/10.34631/sporl.820Keywords:
Dehiscence, Superior Semicircular Canal, Audiogram, Acoustic ReflexesAbstract
Objectives: to identify common clinical characteristics in patients with superior semicircular canal dehiscence (SSCD)in order to increase the diagnostic suspicion of this recently described clinical entity.
Materials and Methods: a retrospective analysis was carried out between 2016 and 2019 and 5 cases were analyzed, corresponding to 8 ears with SSCD, analyzing the accompanying symptoms. The diagnosis of dehiscence was established through computed tomography (CT) of the temporal bone.
Results: Hearing loss was the major complaint being common to all patients. In the 8 ears analyzed, there was a predominance of conduction hearing loss in frequencies below 1000Hz with normal impedance audiometry.
Conclusions: the recognition of these patients, with a third non-physiological window in the bony lining of the superior semicircular canal, makes possible a differential diagnosis that explains a conduction or mixed hearing loss with acoustic reflexes present, thus preventing errors in diagnosis and unnecessary surgery.
References
- Minor LB, Solomon D, Zinreich JS, Zee DS. Sound- and/or pressure induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg. 1998 Mar;124(3):249-58. doi: 10.1001/archotol.124.3.249.
- Niesten ME, Hamberg LM, Silverman JB. Lou KV. et al. Superior canal dehiscence length and location influences clinical presentation and audiometric and cervical vestibular-evoked myogenic potential testing. Audiol Neurootol. 2014;19(2):97-105. doi: 10.1159/000353920
- Bi WL, Brewster R, Poe D, Vernick D, Lee DJ, Eduardo Corrales C. et al. Superior semicircular canal dehiscence syndrome. J Neurosurg. 2017 Dec;127(6):1268-1276. doi: 10.3171/2016.9.JNS16503
- Lee GS, Zhou G, Poe D, Kenna, M. et al. Clinical experience in diagnosis and management of superior semicircular canal dehiscence in children. Laryngoscope 2011 Oct;121(10):2256-61. doi: 10.1002/lary.22134.
- Schutt CA, Neubauer P, Samy RN, Pensak ML. et al. The correlation between obesity, obstructive sleep apnea, and superior semicircular canal dehiscence: a new explanation for an increasingly common problem. Otol Neurotol. 2015 Mar;36(3):551-4. doi: 10.1097/MAO.0000000000000555.
- Zhou G, Gopen Q, Poe DS. Clinical and diagnostic characterization of canal dehiscence syndrome: a great otologic mimicker. Otol Neurotol. 2007 Oct;28(7):920-6. doi: 10.1097/mao.0b013e31814b25f2
- Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope. 2005 Oct;115(10):1717-27. doi: 10.1097/01.mlg.0000178324.55729.b7
- Mikulec AA, McKenna MJ, Ramsey MJ, Rosowski JJ. et al. Superior semicircular canal dehiscence presenting as conductive hearing loss without vertigo. Otol Neurotol. 2004 Mar;25(2):121-9 doi: 10.1097/00129492-200403000-00007.
- Chilvers G, McKay-Davies I. Recent advances in superior semicircular canal dehiscence syndrome. J Laryngol Otol. 2015 Mar;129(3):217-25. doi: 10.1017/S0022215115000183
- Curtin HD. Superior semicircular canal dehiscence syndrome and multidetector row CT. Radiology. 2003 Feb;226(2):312-4. Doi: 10.1148/radiol.2262021327.
- Carey JP, Minor LB, Nager GT. Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg. 2000 Feb;126(2):137-47 doi: 10.1001/archotol.126.2.137.
- Saliba I, Maniakas A, Benamira LZ, Nehme J. et al. Superior canal dehiscence syndrome: clinical manifestations and radiologic correlations. Eur Arch Otorhinolaryngol. 2014 Nov;271(11):2905-14. doi: 10.1007/s00405-013-2711-x.
- Belden CJ, Weg N, Minor LB, Zinreich SJ. CT evaluation of bone dehiscence of the superior semicircular canal as a cause of sound- and/or pressure-induced vertigo. Radiology. 2003 Feb;226(2):337-43. Doi: 10.1148/radiol.2262010897.
- Modugno G, Brandolini C, Savastio G, Ceroni AR et al. Superior semicircular canal dehiscence: a series of 13 cases. ORL J Otorhinolaryngol Relat Spec. 2005;67(3):180-4 doi: 10.1159/000086573.
- Guimarães J, Miranda D, Moreira F. Marçal N, Pereira G, Vilarinho S. et al. Síndrome da deiscência do canal semicircular superior: a propósito de dois casos clínicos. Rev Portuguesa Otorrrinolaringologia e Cirurgia de Cabeça e Pescoço 2011;49(4):281–8. doi: 10.34631/sporl.200
- Naert L, Van de Berg R, Van de Heyning P, Bisdorff A. et al. Aggregating the symptoms of superior semicircular canal dehiscence syndrome. Laryngoscope. 2018 Aug;128(8):1932-8. doi: 10.1002/lary.27062.
- A.G. Shuman, S.S. Rizvi, C.W. Pirouet, Heidenreich KD. Hennebert's sign in superior semicircular canal dehiscence syndrome: a video case report. Laryngoscope. 2012 Feb;122(2):412-4. doi: 10.1002/lary.22413.
- Pereira D, Leonardo A, Duarte D, Oliveira N. Bilateral superior semicircular canal dehiscence: bilateral conductive hearing loss with subtle vestibular symptoms. BMJ Case Rep. 2020 Mar 12;13(3):e233042. doi: 10.1136/bcr-2019-233042.
- Grieser BJ, Kleiser L, Obrist D. Identifying mechanisms behind the Tullio phenomenon: a computational study based on first principles. J Assoc Res Otolaryngol. 2016 Apr;17(2):103-18. doi: 10.1007/s10162-016-0553-0.
- Minor LB, Carey JP, Cremer PD, Lustig LR, Streubel SO, Ruckenstein MJ. Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Otol Neurotol. 2003 Mar;24(2):270-8. doi: 10.1097/00129492-200303000-00023.
- Limb CJ, Carey JP, Srireddy S, Minor LB. Auditory function in patients with surgically treated superior semicircular canal dehiscence. Otol Neurotol. 2006 Oct;27(7):969-80 doi: 10.1097/01.mao.0000235376.70492.8e.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.