Transmastoid Occlusion Surgery for Superior Semicircular Canal Dehiscence Syndrome Improves Patient-Reported Quality-of-Life Measures and corrects cVEMP Thresholds and Amplitudes.
Otol Neurotol
; 42(10): 1534-1543, 2021 12 01.
Article
em En
| MEDLINE
| ID: mdl-34420021
ABSTRACT
OBJECTIVE:
To determine the pre- and postoperative clinical, audiological, vestibular, and patient-reported measures in patients undergoing transmastoid occlusion surgery for superior canal dehiscence syndrome (SCDS). STUDYDESIGN:
Retrospective case review.SETTING:
Tertiary referral centre, UK. PATIENTS All primary transmastoid occlusion surgeries for SCDS were included (tertiary centre, single-surgeon), January 2008 to July 2019.INTERVENTIONS:
Transmastoid superior canal occlusion surgery for SCDS. MAIN OUTCOMEMEASURES:
We collated audiological (pure tone audiogram), vestibular (cervical vestibular evoked myogenic potentials [cVEMPs]), and patient-reported outcome measures (Dizziness Handicap Inventory and subjective symptom grading).RESULTS:
Fifty-two patients (55 ears) met the inclusion criteria. Thirty-one (56%) were female. Mean age was 47âyears (range 29-63) and mean follow-up of 11.2âmonths. Six patients had bilateral disease, four of whom underwent sequential, bilateral surgery.Autophony was the most frequent presenting symptom, improving in 92%.Significant improvements were self-reported in patients' autophony (pâ<â0.0001), pressure- and noise-induced dizziness (pâ<â0.0001 and pâ<â0.0001), aural fullness (pâ=â0.0159), pulsatile tinnitus (pâ<â0.0001), perceived hearing loss (pâ=â0.0058), and imbalance (pâ=â0.0303).Overall Dizziness Handicap Inventory scores reduced from 45.9 to 27.4 (pâ<â0.0001), and across all subgroups of functional (pâ=â0.0003), emotional (pâ<â0.0001), and physical handicap (pâ=â0.0005).A 6.4-dB HL improvement in the air-bone gap (500-1000âHz) occurred (95% confidence intervals 3.3-9.4âdB HL, pâ<â0.0001). There were no dead ears. cVEMP thresholds, when recordable, normalized in all except two ears.CONCLUSIONS:
Transmastoid occlusion is effective at improving patient-reported outcomes and normalizing cVEMP thresholds, though some symptoms, notably disequilibrium, persist to a variable degree.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Potenciais Evocados Miogênicos Vestibulares
/
Deiscência do Canal Semicircular
Tipo de estudo:
Observational_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Otol Neurotol
Ano de publicação:
2021
Tipo de documento:
Article