scholarly journals Case Report: Local Anesthesia Round Window Plugging and Simultaneous Vibrant Soundbridge Implant for Superior Semicircular Canal Dehiscence

2020 ◽  
Vol 11 ◽  
Author(s):  
Giulia Mignacco ◽  
Lorenzo Salerni ◽  
Ilaria Bindi ◽  
Giovanni Monciatti ◽  
Alfonso Cerase ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vibrant Soundbridge ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
The Right ◽  
Canal Dehiscence

The aim of the present study is to report the outcomes of round window reinforcement surgery performed with the application of a Vibrant Soundbridge middle ear implant (VSB; MED-EL) in a patient with superior semicircular canal dehiscence (SSCD) who presented with recurrent vertigo, Tullio phenomenon, Hennebert's sign, bone conduction hypersensitivity, and bilateral moderate to severe mixed hearing loss. Vestibular evoked myogenic potentials (VEMPs) and high-resolution computed tomography (HRCT) confirmed bilateral superior semicircular canal dehiscence while this was not seen in magnetic resonance imaging. The surgical procedure was performed in the right ear as it had worse vestibular and auditory symptoms, a poorer hearing threshold, and greatly altered HRCT and VEMPs findings. With local-assisted anesthesia, round window reinforcement surgery (plugging) with perichondrium was performed with simultaneous positioning of a VSB on the round window niche. At the one and 3 months follow-up after surgery, VSB-aided hearing threshold in the right ear improved to mild, and loud sounds did not elicit either dizziness or pain in the patient.

Mondini-like malformation mimicking otosclerosis and superior semicircular canal dehiscence

2006 ◽  
Vol 120 (5) ◽  
pp. 419-422 ◽  
Author(s):  
M Karlberg ◽  
M Annertz ◽  
M Magnusson
Keyword(s):  
Hearing Loss ◽  
Semicircular Canal ◽  
Bone Conduction ◽  
Low Frequency ◽  
Acoustic Energy ◽  
Vestibular Evoked Myogenic Potentials ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Temporal Bones ◽  
Canal Dehiscence

In 2003, it was reported that superior semicircular canal dehiscence can mimic otosclerosis because of low-frequency bone conduction hearing gain and dissipation of air-conducted acoustic energy through the dehiscence. We report the case of a 17-year-old girl with left-sided combined hearing loss thought to be due to otosclerosis. Bone conduction thresholds were −10 dB at 250 and 500 Hz and she had a 40 dB air–bone gap at 250 Hz. When a tuning fork was placed at her ankle she heard it in her left ear. Acoustic reflexes and vestibular evoked myogenic potentials could be elicited bilaterally. Imaging of the temporal bones showed no otosclerosis, superior semicircular canal dehiscence or large vestibular aqueduct, but a left-sided, Mondini-like dysplasia of the cochlea with a modiolar deficiency could be seen. Mondini-like cochlear dysplasia should be added to the causes of inner-ear conductive hearing loss.

Bilateral superior semicircular canal dehiscence: bilateral conductive hearing loss with subtle vestibular symptoms

2020 ◽  
Vol 13 (3) ◽  
pp. e233042
Author(s):  
Diogo Pereira ◽  
Abílio Leonardo ◽  
Delfim Duarte ◽  
Nuno Oliveira
Keyword(s):  
Hearing Loss ◽  
Semicircular Canal ◽  
Conductive Hearing Loss ◽  
Vestibular Evoked Myogenic Potentials ◽  
Caucasian Woman ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Vestibular Symptoms ◽  
Conductive Hearing ◽  
Canal Dehiscence

Superior semicircular canal dehiscence is caused by a bone defect on the roof of the superior semicircular canal. The estimated prevalence when unilateral varies between 0.4% and 0.7% and is still unknown when bilateral. Patients may present with audiologic and vestibular symptoms that may vary from asymptomatic to disabling. We report a case of a 72-year-old Caucasian woman presented to otolaryngology department reporting imbalance, bilateral pulsatile tinnitus, hypoacusis while being very sensitive to certain sounds. Physical examination was unremarkable, except for the Rinne test that was negative in both sides. The patient underwent an audiometry revealing a mild bilateral conductive hearing loss. A temporal bone CT scan was performed which evidenced bilateral superior semicircular canal dehiscence. Cervical vestibular evoked myogenic potentials and electrocochleography confirmed diagnosis. Although rare, superior semicircular canal dehiscence shall be considered in conductive hearing loss with vestibular symptoms.

Superior semicircular canal dehiscence syndrome

2017 ◽  
Vol 127 (6) ◽  
pp. 1268-1276 ◽  
Author(s):  
Wenya Linda Bi ◽  
Ryan Brewster ◽  
Dennis Poe ◽  
David Vernick ◽  
Daniel J. Lee ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Surgical Repair ◽  
Round Window ◽  
Bony Defect ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Superior Petrosal Sinus ◽  
Adults And Children ◽  
Surgical Options ◽  
Canal Dehiscence

Superior semicircular canal dehiscence (SSCD) syndrome is an increasingly recognized cause of vestibular and/or auditory symptoms in both adults and children. These symptoms are believed to result from the presence of a pathological mobile “third window” into the labyrinth due to deficiency in the osseous shell, leading to inadvertent hydroacoustic transmissions through the cochlea and labyrinth. The most common bony defect of the superior canal is found over the arcuate eminence, with rare cases involving the posteromedial limb of the superior canal associated with the superior petrosal sinus. Operative intervention is indicated for intractable or debilitating symptoms that persist despite conservative management and vestibular sedation. Surgical repair can be accomplished by reconstruction or plugging of the bony defect or reinforcement of the round window through a variety of operative approaches. The authors review the etiology, pathophysiology, presentation, diagnosis, surgical options, and outcomes in the treatment of this entity, with a focus on potential pitfalls that may be encountered during clinical management.

Superior semicircular canal dehiscence simulating otosclerosis

2003 ◽  
Vol 117 (7) ◽  
pp. 553-557 ◽  
Author(s):  
G. Michael Halmagyi ◽  
Swee T. Aw ◽  
Leigh A. McGarvie ◽  
Michael J. Todd ◽  
Andrew Bradshaw ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Vestibular Evoked Myogenic Potentials ◽  
Patient Needs ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Acoustic Reflexes ◽  
Temporal Bones ◽  
Conductive Hearing ◽  
Canal Dehiscence

This is a report of a patient with an air-bone gap, thought 10 years ago to be a conductive hearing loss due to otosclerosis and treated with a stapedectomy. It now transpires that the patient actually had a conductive hearing gain due to superior semicircular canal dehiscence. In retrospect for as long as he could remember the patient had experienced cochlear hypersensitivity to bone-conducted sounds so that he could hear his own heart beat and joints move, as well as a tuning fork placed at his ankle. He also had vestibular hypersensitivity to air-conducted sounds with sound-induced eye movements (Tullio phenomenon), pressure-induced nystagmus and low-threshold, high-amplitude vestibular-evoked myogenic potentials. Furthermore some of his acoustic reflexes were preserved even after stapedectomy and two revisions. This case shows that if acoustic reflexes are preserved in a patient with an air-bone gap then the patient needs to be checked for sound- and pressure-induced nystagmus and needs to have vestibular-evoked myogenic potential testing. If there is sound- or pressure-induced nystagmus and if the vestibular-evoked myogenic potentials are also preserved, the problem is most likely in the floor of the middle fossa and not in the middle ear, and the patient needs a high-resolution spiral computed tomography (CT) of the temporal bones to show this.

scholarly journals Head rotation evoked tinnitus due to superior semicircular canal dehiscence

2009 ◽  
Vol 124 (3) ◽  
pp. 333-335 ◽  
Author(s):  
E-C Nam ◽  
R Lewis ◽  
H H Nakajima ◽  
S N Merchant ◽  
R A Levine
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Semicircular Canal ◽  
Head Rotation ◽  
Bony Defect ◽  
Case Presentation ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
The Right ◽  
Canal Dehiscence

AbstractIntroduction:Superior semicircular canal dehiscence affects the auditory and vestibular systems due to a partial defect in the canal's bony wall. In most cases, sound- and pressure-induced vertigo are present, and are sometimes accompanied by pulse-synchronous tinnitus.Case presentation:We describe a 50-year-old man with superior semicircular canal dehiscence whose only complaints were head rotation induced tinnitus and autophony. Head rotation in the plane of the right semicircular canal with an angular velocity exceeding 600°/second repeatedly induced a ‘cricket’ sound in the patient's right ear. High resolution temporal bone computed tomography changes, and an elevated umbo velocity, supported the diagnosis of superior semicircular canal dehiscence.Conclusion:In addition to pulse-synchronous or continuous tinnitus, head rotation induced tinnitus can be the only presenting symptom of superior semicircular canal dehiscence without vestibular complaints. We suggest that, in our patient, the bony defect of the superior semicircular canal (‘third window’) might have enhanced the flow of inner ear fluid, possibly producing tinnitus.

scholarly journals Superior semicircular canal dehiscence syndrome: Diagnostic criteria consensus document of the committee for the classification of vestibular disorders of the bárány society

2021 ◽  
pp. 1-10
Author(s):  
Bryan K. Ward ◽  
Raymond van de Berg ◽  
Vincent van Rompaey ◽  
Alexandre Bisdorff ◽  
Timothy E. Hullar ◽  
...  
Keyword(s):  
High Resolution ◽  
Diagnostic Criteria ◽  
Semicircular Canal ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Physiological Tests ◽  
Canal Dehiscence

This paper describes the diagnostic criteria for superior semicircular canal dehiscence syndrome (SCDS) as put forth by the classification committee of the Bárány Society. In addition to the presence of a dehiscence of the superior semicircular canal on high resolution imaging, patients diagnosed with SCDS must also have symptoms and physiological tests that are both consistent with the pathophysiology of a ‘third mobile window’ syndrome and not better accounted for by another vestibular disease or disorder. The diagnosis of SCDS therefore requires a combination of A) at least one symptom consistent with SCDS and attributable to ‘third mobile window’ pathophysiology including 1) hyperacusis to bone conducted sound, 2) sound-induced vertigo and/or oscillopsia time-locked to the stimulus, 3) pressure-induced vertigo and/or oscillopsia time-locked to the stimulus, or 4) pulsatile tinnitus; B) at least 1 physiologic test or sign indicating that a ‘third mobile window’ is transmitting pressure including 1) eye movements in the plane of the affected superior semicircular canal when sound or pressure is applied to the affected ear, 2) low-frequency negative bone conduction thresholds on pure tone audiometry, or 3) enhanced vestibular-evoked myogenic potential (VEMP) responses (low cervical VEMP thresholds or elevated ocular VEMP amplitudes); and C) high resolution CT imaging with multiplanar reconstruction in the plane of the superior semicircular canal consistent with a dehiscence. Thus, patients who meet at least one criterion in each of the three major diagnostic categories (symptoms, physiologic tests, and imaging) are considered to have SCDS.

A Comparison of Diagnostic Accuracy of Superior Semicircular Canal Dehiscence in MDCT and MRI, and Coexistence with Tegmen Tympani Dehiscence

2020 ◽  
Author(s):  
Mikail Inal ◽  
Nuray Bayar Muluk ◽  
Mehmet H. Şahan ◽  
Neşe Asal ◽  
Gökçe Şimşek ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Semicircular Canal ◽  
Temporal Distance ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Tegmen Tympani ◽  
Males And Females ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Canal Dehiscence

Abstract Objectives Tegmen tympani dehiscence in temporal multidetector computed tomography (MDCT) and superior semicircular canal dehiscence may be seen together. We investigated superior semicircular canal dehiscence in temporal MDCT and temporal magnetic resonance imaging (MRI). Methods In this retrospective study, 127 temporal MRI and MDCT scans of the same patients were reviewed. In all, 48.8% (n = 62) of cases were male, and 51.2% (n = 65) of cases were female. Superior semicircular canal dehiscence and superior semicircular canal-temporal lobe distance were evaluated by both MDCT and MRI. Tegmen tympani dehiscence was evaluated by MDCT. Results Superior semicircular canal dehiscence was detected in 14 cases (5.5%) by temporal MDCT and 15 cases (5.9%) by temporal MRI. In 13 cases (5.1%), it was detected by both MDCT and MRI. In one case (0.4%), it was detected by only temporal MDCT, and in two cases (0.8%), it was detected by only temporal MRI. Median superior semicircular canal-to-temporal distance was 0.66 mm in both males and females in temporal MDCT and temporal MRI. In both temporal MDCT and temporal MRI, as superior semicircular canal-to-temporal lobe distance increased, the presence of superior semicircular canal dehiscence in temporal MDCT and temporal MRI decreased. Tegmen tympani dehiscence was detected in eight cases (6.3%) on the right side and six cases (4.7%) on the left side. The presence of tegmen tympani dehiscence in temporal MDCT and the presence of superior semicircular dehiscence in MDCT and MRI increased. Conclusion Superior semicircular canal dehiscence was detected by both MDCT and MRI. Due to the accuracy of the MRI method to detect superior semicircular dehiscence, we recommend using MRI instead of MDCT to diagnose superior semicircular canal dehiscence. Moreover, there is no radiation exposure from MRI.

Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence syndrome

2013 ◽  
Vol 127 (7) ◽  
pp. 705-707 ◽  
Author(s):  
A Nikkar-Esfahani ◽  
D Whelan ◽  
A Banerjee
Keyword(s):  
Semicircular Canal ◽  
Round Window ◽  
Round Window Membrane ◽  
Superior Semicircular Canal Dehiscence ◽  
Tullio Phenomenon ◽  
Superior Semicircular Canal ◽  
Case Surgery ◽  
Post Operation ◽  
Round Window Niche ◽  
Canal Dehiscence

AbstractBackground:Conductive hyperacusis in superior semicircular canal dehiscence syndrome occurs due to the presence of a ‘third window’ created by the dehiscence. Reversible blocking of the round window can, in theory, cause a reduction in the compression-related volume displacement, and thereby minimise symptoms of conductive hyperacusis. This study describes a technique of permeatal blocking of the round window.Method:The tympanomeatal flap is elevated and the round window niche is identified. The round window membrane is subsequently identified and occluded with bone wax, muscle and fascia, in three separate layers. Finally, the tympanomeatal flap is reflected, and an ear wick is inserted.Results:Two patients who underwent the procedure reported a reduction in symptoms. Importantly, no Tullio phenomenon was reported post-operation.Conclusion:Blocking of the round window can be used to control symptoms of superior semicircular canal dehiscence syndrome in patients who present solely with symptoms of conductive hyperacusis. This technique provides an alternative to resurfacing techniques. The procedure is simple to perform, reversible and can be undertaken as day-case surgery.

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