J Neurol Surg B Skull Base 2018; 79(S 01): S1-S188
DOI: 10.1055/s-0038-1633737
Poster Presentations
Georg Thieme Verlag KG Stuttgart · New York

Middle Cranial Fossa Approach for the Repair of Superior Semicircular Canal Dehiscence Is Associated with Greater Symptom Resolution Compared with Transmastoid Approach

Thien Nguyen
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Carlito Lagman
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
John P. Sheppard
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Prasanth Romiyo
2   Cooper Medical School of Rowan University, Camden, New Jersey, United States
,
Courtney Duong
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Giyarpuram N. Prashant
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Quinton Gopen
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Isaac Yang
1   David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
02 February 2018 (online)

 

Background Superior semicircular canal dehiscence (SSCD) is a disorder of the skull base that is gaining increasing recognition among neurosurgeons. Traditionally, the middle cranial fossa (MCF) approach has been used for the surgical repair of SSCD. However, the transmastoid (TM) approach is an alternative strategy that has demonstrated promising results.

Methods We performed independent searches of a popular database to identify studies that described outcomes following the surgical repair of SSCD through MCF and TM approaches. The primary outcome was symptom resolution.

Results Our analysis included 24 studies that described 230 patients who underwent either an MCF (n = 148, 64%) approach or a TM (n = 82, 36%) approach for primary surgical repair of SSCD. A greater percentage of patients in the MCF group experienced resolution of auditory symptoms (72 vs. 59%, p = 0.012), aural fullness (83 vs. 55%, p = 0.049), hearing loss (57 vs. 31%, p = 0.026), and disequilibrium (75 vs. 44%, p = 0.001) when compared with the TM group. The MCF approach was also associated with higher odds of symptom resolution for auditory symptoms (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.14–2.82), aural fullness (OR: 4.02, 95% CI: 1.04–15.53), hearing loss (OR: 2.91, 95% CI: 1.14–7.42), and disequilibrium (OR: 3.94, 95% CI: 1.78–8.73). The mean follow-up was 9 months (SD: 8.7).

Conclusion The literature suggests that the MCF approach is associated with higher rates of auditory symptom, aural fullness, hearing loss, and disequilibrium resolution after surgery as compared with the TM approach. This information could help facilitate patient discussions.