Sealing of superior semicircular canal dehiscence is associated with improved balance outcomes postoperatively versus plugging of the canal in middle fossa craniotomy repairs: a case series

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  • 1 Departments of Head and Neck Surgery and
  • 2 Neurosurgery,
  • 3 Office of the Patient Experience,
  • 4 Radiation Oncology, and the
  • 5 UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center, Los Angeles; and
  • 6 Department of Neurosurgery,
  • 7 Los Angeles Biomedical Research Institute (LA BioMed), and
  • 8 Surgery at Harbor–UCLA Medical Center, Torrance, California
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OBJECTIVE

The authors compared postoperative symptoms between patients with sealed and those with plugged semicircular canal dehiscence repairs.

METHODS

In total, 136 ears from 118 patients who underwent surgical repair for semicircular canal dehiscence were identified via chart review. Data from postoperative MRI scans showing preservation or loss of semicircular canal fluid signal and postoperative reports of autophony, amplification, aural fullness, tinnitus, hyperacusis, hearing loss, vertigo, dizziness, disequilibrium, oscillopsia, and headache were amalgamated and analyzed.

RESULTS

Patients with preservation of fluid signal were far less likely to have dizziness postoperatively (p = 0.007, OR 0.158, 95% CI 0.041–0.611). In addition, these patients were more likely to have tinnitus postoperatively (p = 0.028, OR 3.515, 95% CI 1.145–10.787).

CONCLUSIONS

The authors found that superior semicircular canal dehiscence patients who undergo sealing without plugging have improved balance outcomes but show more tinnitus postoperatively than patients who undergo plugging.

ABBREVIATIONS SSCD = superior semicircular canal dehiscence.

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Contributor Notes

Correspondence Quinton Gopen: UCLA Head and Neck Surgery, Los Angeles, CA. qgopen@mednet.ucla.edu.

INCLUDE WHEN CITING Published online June 28, 2019; DOI: 10.3171/2019.4.JNS19264.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • 1

    Amoodi HA, Makki FM, McNeil M, Bance M: Transmastoid resurfacing of superior semicircular canal dehiscence. Laryngoscope 121:11171123, 2011

    • Search Google Scholar
    • Export Citation
  • 2

    Ateş O, Cayli SR, Gürses I: Bone wax can cause foreign body granuloma in the medulla oblongata. Br J Neurosurg 18:538540, 2004

  • 3

    Beckett JS, Chung LK, Lagman C, Voth BL, Jacky Chen CH, Gaonkar B, : A method of locating the dehiscence during middle fossa approach for superior semicircular canal dehiscence surgery. J Neurol Surg B Skull Base 78:353358, 2017

    • Search Google Scholar
    • Export Citation
  • 4

    Beckett JS, Lagman C, Chung LK, Bui TT, Lee SJ, Voth BL, : Computerized assessment of superior semicircular canal dehiscence size using advanced morphological imaging operators. J Neurol Surg B Skull Base 78:197200, 2017

    • Search Google Scholar
    • Export Citation
  • 5

    Beyea JA, Agrawal SK, Parnes LS: Transmastoid semicircular canal occlusion: a safe and highly effective treatment for benign paroxysmal positional vertigo and superior canal dehiscence. Laryngoscope 122:18621866, 2012

    • Search Google Scholar
    • Export Citation
  • 6

    Bi WL, Brewster R, Poe D, Vernick D, Lee DJ, Eduardo Corrales C, : Superior semicircular canal dehiscence syndrome. J Neurosurg 127:12681276, 2017

    • Search Google Scholar
    • Export Citation
  • 7

    Crovetto M, Areitio E, Elexpuru J, Aguayo F: Transmastoid approach for resurfacing of superior semicircular canal dehiscence. Auris Nasus Larynx 35:247249, 2008

    • Search Google Scholar
    • Export Citation
  • 8

    Gibbs L, Kakis A, Weinstein P, Conte JE Jr: Bone wax as a risk factor for surgical-site infection following neurospinal surgery. Infect Control Hosp Epidemiol 25:346348, 2004

    • Search Google Scholar
    • Export Citation
  • 9

    Hillman TA, Kertesz TR, Hadley K, Shelton C: Reversible peripheral vestibulopathy: the treatment of superior canal dehiscence. Otolaryngol Head Neck Surg 134:431436, 2006

    • Search Google Scholar
    • Export Citation
  • 10

    Lagman C, Ong V, Chung LK, Elhajjmoussa L, Fong C, Wang AC, : Pediatric superior semicircular canal dehiscence: illustrative case and systematic review. J Neurosurg Pediatr 20:196203, 2017

    • Search Google Scholar
    • Export Citation
  • 11

    Minor LB: Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 115:17171727, 2005

  • 12

    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 124:249258, 1998

    • Search Google Scholar
    • Export Citation
  • 13

    Mueller SA, Vibert D, Haeusler R, Raabe A, Caversaccio M: Surgical capping of superior semicircular canal dehiscence. Eur Arch Otorhinolaryngol 271:13691374, 2014

    • Search Google Scholar
    • Export Citation
  • 14

    Shargorodsky J, Curhan GC, Farwell WR: Prevalence and characteristics of tinnitus among US adults. Am J Med 123:711718, 2010

  • 15

    Ung N, Chung LK, Lagman C, Bhatt NS, Barnette NE, Ong V, : Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence. J Clin Neurosci 43:103107, 2017

    • Search Google Scholar
    • Export Citation

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