Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-24T05:45:35.875Z Has data issue: false hasContentIssue false
  • English
  • Français

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 ,
T A Kennedy  and
S P Gubbels
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]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

MastoidSemicircular CanalsVestibular Evoked Myogenic PotentialsHearing Loss
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 174 - 178
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Minor, 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;124:249–58CrossRefGoogle ScholarPubMed
2Minor, 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;942:259–73CrossRefGoogle ScholarPubMed
3Banerjee, A, Whyte, A, Atlas, MD. Superior canal dehiscence: review of a new condition. Clin Otolaryngol 2005;30:9–15CrossRefGoogle ScholarPubMed
4Gopen, Q, Zhou, G, Poe, D, Kenna, M, Jones, D. Posterior semicircular canal dehiscence: first reported case series. Otol Neurotol 2010;31:339–44CrossRefGoogle ScholarPubMed
5Krombach, GA, DiMartino, E, Schmitz-Rode, T, Prescher, A, Haage, P, Kinzel, S et al. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence. Eur Radiol 2003;13:1444–50Google Scholar
6Brantberg, K, Bagger-Sjöbäck, D, Mathiesen, T, Witt, H, Pansell, T. Posterior canal dehiscence syndrome caused by an apex cholesteatoma. Otol Neurotol 2006;27:531–4Google Scholar
7Zhou, G, Gopen, Q, Poe, DS. Clinical and diagnostic characterization of canal dehiscence syndrome: a great otologic mimicker. Otol Neurotol 2007;28:920–6CrossRefGoogle ScholarPubMed
8Chien, WW, Carey, JP, Minor, LB. Canal dehiscence. Curr Opin Neurol 2011;24:25–31CrossRefGoogle ScholarPubMed
9Minor, LB. Superior canal dehiscence syndrome. Am J Otol 2000;21:9–19CrossRefGoogle ScholarPubMed
10Rajenderkumar, D, Farrell, KL, Alles, RM, Savy, L. Multiple dehiscence of semicircular canals. J Laryngol Otol 2007;121:80–2CrossRefGoogle ScholarPubMed
11Beyea, 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 2012;122:1862–6CrossRefGoogle ScholarPubMed