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
Kübra ÇOBANa, Gülfem BEYAZPINARa, Seda KİBAROĞLUb, Feride KURAL RAHATLIc,
Erdinç AYDINa
aDepartment of Otorhinolaryngology, Başkent University Faculty of Medicine, Antalya, TURKEY
bDepartment of Neurology, Başkent University Faculty of Medicine, Ankara, TURKEY
cDepartment of Radiology, Başkent University Faculty of Medicine, Ankara, TURKEY
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.
Keywords: Idiopathic intracranial hypertension; superior semicircular canal dehiscence; vertigo; hearing loss
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.
Anahtar Kelimeler: İdiyopatik intrakraniyal hipertansiyon; superior semisirküler kanal dehisansı; vertigo; işitme kaybı
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