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Simultaneous, unilateral plugging of superior and posterior semicircular canal dehiscences to treat debilitating hyperacusis

Published online by Cambridge University Press:  30 January 2014

P T Dang
Affiliation:
School of Medicine and Public Health, University of Wisconsin – Madison, USA
T A Kennedy
Affiliation:
Department of Radiology, Section of Neuroradiology, University of Wisconsin – Madison, USA
S P Gubbels*
Affiliation:
Department of Surgery, Division of Otolaryngology and Waisman Center, University of Wisconsin – Madison, USA
*
Address for correspondence: Dr Samuel P Gubbels, K4/719 CSC, 600 Highland Av, Madison, WI 53792-3284, USA Fax: +1 (608) 252 0926 E-mail: [email protected]

Abstract

Objective:

To describe a case of bilateral superior and posterior semicircular canal dehiscences, and the use of a unilateral transmastoid approach to address both right-sided defects simultaneously.

Case report:

In a patient with right-sided hyperacusis, bilateral dehiscence of both the superior and the posterior semicircular canals was identified, located adjacent to the common crus, together with a right-sided, anterosuperiorly positioned sigmoid sinus and a high-riding jugular bulb. Results for audiography and cervical vestibular evoked myogenic potential testing were consistent with right-sided semicircular canal dehiscence. At surgery, a right-sided transmastoid approach provided access to plug both defects simultaneously, following posterior mobilisation of the sigmoid sinus. The patient's hyperacusis was completely resolved, with a 10–30 dB improvement in his right ear air conduction hearing, without decrement in bone conduction.

Conclusion:

In properly selected patients, a transmastoid approach can be used to effectively manage superior semicircular canal dehiscence and posterior semicircular canal dehiscence simultaneously. Pre-operative computed tomography is recommended to evaluate the dehiscence sites and to identify complicating vascular anatomy.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2014 

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