ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
kulak burun boÄŸaz
ve baÅŸ boyun cerrahisi dergisi
http://dergi.kbb-bbc.org.tr
Kayıtlı İndeksler








ORIGINAL RESEARCH

Audiovestibular Findings in Superior Semicircular Canal Dehiscence Syndrome
Superior Semisirküler Kanal Dehissansı Sendromunda Odyovestibüler Bulgular
Received Date : 22 Aug 2022
Accepted Date : 26 Sep 2022
Available Online : 05 Oct 2022
Doi: 10.24179/kbbbbc.2022-93010 - Makale Dili: EN
KBB ve BBC Dergisi. 2023;31(1):14-23
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
Objective: Superior semicircular canal dehiscence (SSCD) is a rare syndrome caused by a bone defect in the superior semicircular canal. The aim of this study was to evaluate the audiovestibular clinical findings in patients diagnosed with SSCD syndrome. Material and Methods: This study was designed as clinical retrospective research. The archives of patients admitted to the otolaryngology clinic between June 2018-June 2022 were examined. Records of ears diagnosed with SSCD syndrome have been reached. The audiovestibular symptoms, clinical findings, and high-resolution computed tomography (HRCT) scans of these ears were presented. Results: As a result of the retrospective evaluation, 5 ears diagnosed with SSCD syndrome were obtained. Audiovestibular symptoms and clinical findings such as pure tone audiometry, tympanometry, acoustic reflex, video head impulse test, videonystagmography, cervical and ocular vestibular evoked myogenic potentials (VEMP) test results were evaluated. HRCT scans of all ears were interpreted. Conclusion: Symptoms such as sound- and/or pressure-induced vertigo (Tullio phenomenon, Hennebert's sign), oscillopsia, hyperacusis, autophony, pulsatile tinnitus, aural fullness; findings such as elevated bone-conduction thresholds, increasing of VEMP wave amplitude, decreasing of VEMP response threshold, decreasing of semicircular canal gain suggestive of SSCD.
ÖZET
Amaç: Superior semisirküler kanal dehissansı [superior semicircular canal dehiscence (SSCD)], superior semisirküler kanaldaki kemik defektinin neden olduğu nadir görülen bir sendromdur. Bu çalışmanın amacı, SSCD sendromu tanısı alan hastalarda odyovestibüler klinik bulguları değerlendirmektir. Gereç ve Yötemler: Bu çalışma, klinik retrospektif araştırma olarak tasarlanmıştır. Haziran 2018-Haziran 2022 tarihleri arasında kulak-burun-boğaz kliniğine başvuran hastaların kayıtları incelenmiştir. SSCD sendromu tanısı alan hastaların verilerine ulaşılmıştır. Bu hastaların odyovestibüler semptomları, klinik bulguları ve yüksek çözünürlüklü bilgisayarlı tomografi [high-resolution computed tomography (HRCT)] taramaları sunulmuştur. Bulgular: Retrospektif değerlendirme sonucunda, SSCD sendromu tanısı alan 5 kulağa ulaşılmıştır. Bu 5 kulağın, odyovestibüler semptomları ve saf ses odyometri, timpanometri, akustik refleks, video head impulse test, videonistagmografi, servikal ve oküler vestibüler uyarılmış miyojenik potansiyeller [vestibular evoked myogenic potentials (VEMP)] test sonuçları gibi klinik bulguları değerlendirilmiştir. Tüm kulakların HRCT taramaları yorumlanmıştır. Sonuç: Yüksek şiddetli akustik uyaran (Tullio fenomeni) ve/veya basınçla (Hennebert belirtisi) ortaya çıkan vertigo ve/veya nistagmus, osilopsi, hiperakuzi, otofoni, kulakta dolgunluk hissi, pulsatil tinnitus gibi semptomlar; saf ses odyometri testinde kemik eşiklerinin düşmesi, vestibüler uyarılmış miyojenik potansiyeller testinde dalga amplitüdünün artması, VEMP eşiklerinin düşmesi, video head impulse testte semisirküler kanal kazançlarında azalma gibi bulgular SSCD sendromunu düşündürür.
KAYNAKLAR
  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):249-58. [Crossref]  [PubMed] 
  2. Bi WL, Brewster R, Poe D, Vernick D, Lee DJ, Eduardo Corrales C, et al. Superior semicircular canal dehiscence syndrome. J Neurosurg. 2017;127(6):1268-76. [Crossref]  [PubMed] 
  3. Nikkar-Esfahani A, Whelan D, Banerjee A. Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence syndrome. J Laryngol Otol. 2013;127(7):705-7. [Crossref]  [PubMed] 
  4. Minor LB, Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N. Symptoms and signs in superior canal dehiscence syndrome. Ann N Y Acad Sci. 2001;942:259-73. [Crossref]  [PubMed] 
  5. Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope. 2005;115(10):1717-27. [Crossref]  [PubMed] 
  6. Browaeys P, Larson TL, Wong ML, Patel U. Can MRI replace CT in evaluating semicircular canal dehiscence? AJNR Am J Neuroradiol. 2013;34(7):1421-7. [Crossref]  [PubMed]  [PMC] 
  7. Mau C, Kamal N, Badeti S, Reddy R, Ying YM, Jyung RW, et al. Superior semicircular canal dehiscence: Diagnosis and management. J Clin Neurosci. 2018;48:58-65. [Crossref]  [PubMed] 
  8. Streubel SO, Cremer PD, Carey JP, Weg N, Minor LB. Vestibular-evoked myogenic potentials in the diagnosis of superior canal dehiscence syndrome. Acta Otolaryngol Suppl. 2001;545:41-9. [Crossref]  [PubMed] 
  9. Zuniga MG, Janky KL, Nguyen KD, Welgampola MS, Carey JP. Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol. 2013;34(1):121-6. [Crossref]  [PubMed]  [PMC] 
  10. Janky KL, Nguyen KD, Welgampola M, Zuniga MG, Carey JP. Air-conducted oVEMPs provide the best separation between intact and superior canal dehiscent labyrinths. Otol Neurotol. 2013;34(1):127-34. [Crossref]  [PubMed]  [PMC] 
  11. Thabet EM, Abdelkhalek A, Zaghloul H. Superior semicircular canal dehiscence syndrome as assessed by oVEMP and temporal bone computed tomography imaging. Eur Arch Otorhinolaryngol. 2012;269(5):1545-9. [Crossref]  [PubMed] 
  12. Niesten ME, McKenna MJ, Herrmann BS, Grolman W, Lee DJ. Utility of cVEMPs in bilateral superior canal dehiscence syndrome. Laryngoscope. 2013;123(1):226-32. [Crossref]  [PubMed] 
  13. Hunter JB, Patel NS, O'Connell BP, Carlson ML, Shepard NT, McCaslin DL, et al. Cervical and ocular VEMP testing in diagnosing superior semicircular canal dehiscence. Otolaryngol Head Neck Surg. 2017;156(5):917-23. [Crossref]  [PubMed] 
  14. Govender S, Fernando T, Dennis DL, Welgampola MS, Colebatch JG. Properties of 500Hz air- and bone-conducted vestibular evoked myogenic potentials (VEMPs) in superior canal dehiscence. Clin Neurophysiol. 2016;127(6):2522-31. [Crossref]  [PubMed] 
  15. Pereira D, Leonardo A, Duarte D, Oliveira N. Bilateral superior semicircular canal dehiscence: bilateral conductive hearing loss with subtle vestibular symptoms. BMJ Case Rep. 2020;13(3):e233042. [Crossref]  [PubMed]  [PMC] 
  16. Mukherjee P, Chiarovano E, Cheng K, Manzari L, McGarvie LA, MacDougall HG. Video-head impulse test in superior canal dehiscence. Acta Otolaryngol. 2021;141(5):471-5. [Crossref]  [PubMed]Â