J Neurol Surg B Skull Base 2012; 73(04): 225-229
DOI: 10.1055/s-0032-1312713
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transmastoid Repair of Superior Semicircular Canal Dehiscence

Yi Chen Zhao
1   Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
,
Thomas Somers
2   ENT Department, European Institute for Otorhinolaryngology, Sint-Augustinus Hospital, Antwerp, Belgium
,
Joost van Dinther
2   ENT Department, European Institute for Otorhinolaryngology, Sint-Augustinus Hospital, Antwerp, Belgium
,
Robby Vanspauwen
2   ENT Department, European Institute for Otorhinolaryngology, Sint-Augustinus Hospital, Antwerp, Belgium
,
Jacob Husseman
1   Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
,
Robert Briggs
1   Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
› Author Affiliations
Further Information

Publication History

09 September 2010

07 December 2011

Publication Date:
17 May 2012 (online)

Abstract

Objective/Hypothesis Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the Sup SC. Recently, a transmastoid approach for plugging of the Sup SC has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach.

Design This is a retrospective multi-institutional case series.

Method We included 10 patients in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, vestibular evoked myogenic potential, and computed tomography findings. A transmastoid approach was used for plugging of the Sup SC. Either a single fenestration was created at the site of dehiscence or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence.

Results All patients who underwent this procedure had good symptom control and hearing preservation postoperatively.

Conclusion In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach.

 
  • References

  • 1 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; 124 (3) 249-258
  • 2 Minor LB, Carey JP, Cremer PD, Lustig LR, Streubel S-O, Ruckenstein MJ. Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Otol Neurotol 2003; 24 (2) 270-278
  • 3 Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005; 115 (10) 1717-1727
  • 4 Agrawal SK, Parnes LS. Transmastoid superior semicircular canal occlusion. Otol Neurotol 2008; 29 (3) 363-367
  • 5 Deschenes GR, Hsu DP, Megerian CA. Outpatient repair of superior semicircular canal dehiscence via the transmastoid approach. Laryngoscope 2009; 119 (9) 1765-1769
  • 6 Vlastarakos PV, Proikas K, Tavoulari E, Kikidis D, Maragoudakis P, Nikolopoulos TP. Efficacy assessment and complications of surgical management for superior semicircular canal dehiscence: a meta-analysis of published interventional studies. Eur Arch Otorhinolaryngol 2009; 266 (2) 177-186
  • 7 Roditi RE, Eppsteiner RW, Sauter TB, Lee DJ. Cervical vestibular evoked myogenic potentials (cVEMPs) in patients with superior canal dehiscence syndrome (SCDS). Otolaryngol Head Neck Surg 2009; 141 (1) 24-28
  • 8 Mikulec AA, Poe DS, McKenna MJ. Operative management of superior semicircular canal dehiscence. Laryngoscope 2005; 115 (3) 501-507
  • 9 Brantberg K, Bergenius J, Mendel L, Witt H, Tribukait A, Ygge J. Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 2001; 121 (1) 68-75
  • 10 Kirtane MV, Sharma A, Satwalekar D. Transmastoid repair of superior semicircular canal dehiscence. J Laryngol Otol 2009; 123 (3) 356-358
  • 11 Han SJ, Song MH, Kim J, Lee WS, Lee HK. Classification of temporal bone pneumatization based on sigmoid sinus using computed tomography. Clin Radiol 2007; 62 (11) 1110-1118
  • 12 Makki FM, Amoodi HA, van Wijhe RG, Bance M. Anatomic analysis of the mastoid tegmen: slopes and tegmen shape variances. Otol Neurotol 2011; 32 (4) 581-588
  • 13 Kim TH, Nam BH, Park CI. Histologic changes of lateral semicircular canal after transection and occlusion with various materials in chinchillas. Korean J Otolaryngol Head Neck Surg 2002; 45 (4) 318-321