Superior semi-circular canal dehiscence - Surgical approach
DOI:
https://doi.org/10.34631/sporl.308Keywords:
Superior semi-circular canal dehiscence, vertigo, Tullio phenomenon, Hennebert’s sign, middle fossaAbstract
Introduction: Superior semi-circular canal dehiscence (SCCD) is a rare but treatable cause of vertigo. It is characterized by the presence of Tullio phenomenon, Hennebert’s sign and conductive hearing loss with the presence of acoustic reflex. The diagnosis is confirmed by high resolution CT of the temporal bone. The treatment, in the case of incapacitating symptoms, is surgical.
Description of the case: We describe the case of a 36 year old woman with SCCD, with complete dehiscence on the right side and thinning of the bone on the left. The patient underwent surgery, in the Department of Otorhinolaryngology of the CUF Porto Hospital, through a middle fossa approach with resurfacing of the superior semicircular canal. There was a complete resolution of symptoms.
Discussion: There are two possible approaches, middle fossa and transmastoid, along with two different surgical options, plugging or resurfacing. The transmastoid approach, although more familiar to the otorhinolaryngologist, allows only the plugging of the SCCD, which is associated with a higher risk of injury to the vestibular and cochlear structures. The middle fossa approach, although more invasive, lets you choose between plugging and resurfacing.
Conclusion: The middle fossa approach, with resurfacing, allowed the resolution of symptoms with functional preservation.
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