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Superior semicircular canal dehiscence: a narrative review

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  07 October 2021

G Kontorinis  and
T Lenarz
G Kontorinis*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
T Lenarz
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hanover Medical School, Hanover, Germany
*
Author for correspondence: Mr Georgios Kontorinis, Department of Otorhinolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, Scotland, UK E-mail: [email protected]
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Abstract

Background

Described just over 20 years ago, superior semicircular canal dehiscence remains a relatively unknown and easily missed cause of dizziness and auditory symptoms.

Objective

This review focused on the origin, presenting symptoms and underlying pathophysiology of superior semicircular canal dehiscence, and the available treatment options.

Main findings and conclusion

The bony dehiscence acts as a ‘third window’, affecting inner-ear homeostasis, and resulting in hypersensitivity and a vestibular response to lower sound level stimuli. The third window effect explains the pressure- and sound-induced vertigo, oscillopsia, and nystagmus, as well as autophony, conductive hyperacusis and tinnitus. The origin of superior semicircular canal dehiscence is linked to the combination of a congenital or developmental factor, and a ‘second event’ like head trauma, rapid pressure changes or age-related factors. Computed tomography of the temporal bone and reduced vestibular-evoked myogenic potential thresholds can confirm the diagnosis. Despite only retrospective cohorts, surgery is considered a safe treatment option, targeting mainly vestibular but also auditory symptoms, with transmastoid approaches gaining popularity.

Keywords

DizzinessHearing LossLabyrinthVertigoVestibular Evoked Myogenic Potential
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 4 , April 2022 , pp. 284 - 292
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr G Kontorinis takes responsibility for the integrity of the content of the paper

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