J Neurol Surg B Skull Base 2020; 81(S 01): S1-S272
DOI: 10.1055/s-0040-1702460
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

Superior Semicircular Canal Dehiscence Revisional Surgery Outcomes

Kevin Ding
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Prasanth Romiyo
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Edwin Ng
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Dillon Dejam
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Roan N. Anderson
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Adam Enomoto
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Courtney Duong
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
John P. Sheppard
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Matthew Z. Sun
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
H. Westley Phillips
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Quinton Gopen
2   Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
,
Isaac Yang
2   Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2020 (online)

 

Background: Revisional repair of superior semicircular canal dehiscence due to a failed primary surgery poses additional risks to patients, such as the formation of scar tissue that may worsen preoperative symptoms. Though the middle cranial fossa (MCF) approach offers better intraoperative visualization of the dehiscence and greater postoperative symptom resolution, the current literature lacks evaluation of surgical approaches for revisional SSCD surgery.

Methods: We retrospectively identified a cohort of 25 patients who had undergone revisional surgery at our institution. Patient demographics, primary and secondary surgical approach, dates of consultation, and most recent follow-up were noted. Preoperative and postoperative symptoms of autophony, amplification, aural fullness, tinnitus, hyperacusis, hearing loss, vertigo, dizziness, imbalance, oscillopsia, and headache were recorded.

Results: Mean age was 52.2 ± 11.2 years with 8 (32%) males and 17 females (68%). Twelve of these patients had a primary surgery using the middle cranial fossa approach, and seven patients had a primary surgery using the transmastoid approach. Six had a primary combined MCF-TM approach. All secondary revisions for SSCD were performed through a middle cranial fossa approach. Seventeen(68%) of the revisions were performed on left-sided lesions. Three (12%) of the original surgeries were complicated by CSF leakage. Total 17 patients (68%) reported previous ear anomalies, and 14 (56%) had bilateral SSCD. No mentions of preoperative ear trauma, autophony, amplification, aural fullness, tinnitus, hyperacusis, hearing loss, vertigo, dizziness, imbalance, oscillopsia, or headache were made in the medical documents

Conclusion: The MCF approach for SSCD surgery is comparable to TM and combined MCF-TM outcomes for patients undergoing revisional surgery. However, given the advantages of the MCF approach intraoperatively, it should still be a primary consideration when planning revisional cases.

Table 1

Demographics

Variable

Value

Patients, n

25

Age (y)

Mean ± SD

54 ± 11.2

Range

32–74

Sex, n (%)

Female

17 (68)

Male

8 (32)

Characteristics, n (%)

Bilateral

14 (56)

Previous ear anomaly

17 (68)

Primary approach

MCF

12 (48)

TM

7 (28)

Combined

3 (12)

MCF then TM

2 (8)

Abbreviations: MCF, middle cranial fossa; n, population; SD, standard deviation; TM, transmastoid.