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ORIGINAL RESEARCH

Superior Semicircular Canal Dehiscence in Idiopathic Intracranial Hypertension: Preliminary Report
İdiyopatik İntrakraniyal Hipertansiyon Hastalarında Süperior Semisirküler Kanal Dehisansı: Ön Rapor
Received Date : 02 Jun 2020
Accepted Date : 14 Jul 2020
Available Online : 30 Oct 2020
Doi: 10.24179/kbbbbc.2020-77061 - Makale Dili: EN
KBB ve BBC Dergisi. 2021;29(1):26-32
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Amaç: İdiyopatik intrakraniyal hipertansiyon (IIH), tanımlanabilir herhangi bir nedeni olmayan kafa içi basıncı yüksekliği durumudur. Obezite nedeni ile dünya çapında görülme sıklığı artmaktadır. Bu patolojinin tegmental dehisans ve spontan beyin-omurilik sıvısı (BOS) kaçaklarıyla güçlü bir ilişkisi vardır. Superior semisirküler kanal dehisansı (SSKD) da literatürde obeziteyle ilişkilidir. Bu çalışmanın amacı, IIH hastalarında SSKD insidansını belirlemek, SSKD'li IIH hastalarında odyovestibüler bulguları değerlendirmek ve bu birlikteliğe neden olan olası patogenetik mekanizmaları tartışmaktır. Gereç ve Yöntemler: 2016-2018 yılları arasında nöroloji bölümünde IIH tanısı konulmuş 25 ardışık hasta değerlendirildi. Gerekli kriterleri yerine getiren ve bu çalışmaya katılmayı kabul eden 10 hasta çalışma grubuna alındı. Odyometri, timpanometri, vestibüler uyarılmış miyojenik potansiyeller (VEMP) testleri ve yüksek çözünürlüklü bilgisayarlı tomografi (HRCT) görüntülemeleri yapıldı. Kontrol grubu, kliniğimize çeşitli şikâyetlerle başvuran ve 2016-2018 yılları arasında HRCT uygulanan, yaş ve cinsiyet uyumlu, 20 hastadan oluşturuldu. Bulgular: Çalışma grubunda IIH olan 1 (%10) hastada SSKD tespit edildi. İki (%20) hastada kemik kanalında incelme mevcuttu. Kontrol grubundaki hiçbir hastada radyografik SSKD veya kemik kanalda incelme saptanmadı. SSKD'li hastada VEMP'de patolojik bulgular tespit edildi. Sonuç: Sonuçlarımız istatistiksel olarak anlamlı olmamakla birlikte, SSKD insidansı IIH'de daha yüksek görünmektedir. Geniş hasta serileriyle yapılacak ileriye dönük çalışmalar esastır.
ÖZET
Objective: Idiopathic intracranial hypertension (IIH), is a challenging condition with raised intracranial pressure without any identifiable cause. It’s incidence increases due to it’s close association with obesity. This pathology has strong relation with tegmental dehiscence and spontaneous cerebrospinal fluid (CSF) leaks. There are reports of tegmental dehiscence, spontaneous CSF leaks ocurring with SSCD. Superior semicircular canal dehiscence is also associated with obesity in the literature. The aim of this study is to determine the incidence of SSCD in IIH patients, to evaluate the audiovestibular findings in IIH patients with SSCD, and to discuss the possible pathogenetic mechanisms causing this co-occurence. Material and Methods: Twenty five consecutive patients diagnosed with IIH in the neurology department between 2016-2018 were evaluated. Ten patients fulfilling the necessary criteria and accepting to participate in this study, were enrolled in the study group. Audiometry, tympanometry, vestibular evoked myogenic potentials (VEMP) tests and high resolution computed tomography (HRCT) imagings were performed. The control group was constituded of 20 age and sex matched patients attended to our clinic with various other complaints, and to whom HRCT was conducted between 2016 and 2018. Results: Among the study group 1 (10%) patient with IIH had SSCD. Two (20%) patients had thinning in the bony canal. None of the patients in the control group had neither radiographic SSCD, nor bony thinning. Patient with SSCD had pathological signs in VEMP. Conclusion: According to our results, though not statistically significant, the incidence of SSCD seems higher in IIH. The incidence of bony thinning also seems more frequent in IIH. However further studies with wide patient series are essential.
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