Prospective Analysis of an Evidence-Based Symptom Set in Superior Canal Dehiscence Syndrome.

INTRODUCTION: Superior canal dehiscence syndrome (SCDS) is characterized by a defect in the bone overlying the superior semicircular canal. This third mobile window generates an abnormal low-impedance pathway for sound/pressure transmission into the inner ear resulting in the characteristic symptoms. OBJECTIVE: To perform a prospective analysis of symptoms in patients with SCDS. METHODS: An aggregated symptom set was studied prospectively and compared with a healthy control group. The 31 items inquired about the presence and severity of symptoms. Initial comparison between both groups was performed using the Kolmogorov-Smirnov test and nonparametric Mann-Whitney U test. For analysis of the internal consistency, the Cronbach's alpha coefficient was determined. Finally, the prevalence of symptoms obtained in the present study was compared to the prevalence of symptoms obtained as part of a recent retrospective systematic review. RESULTS: Responses from the 29 patients with SCDS in the case group and the 58 healthy controls were not normally distributed. Those with SCDS had a higher prevalence and more severe symptoms for almost all items. The Cronbach's alpha coefficient of 0.969 indicates an excellent internal consistency. The prospective prevalence of most symptoms was higher than the retrospective prevalence reported earlier. CONCLUSIONS: SCDS causes a variety of vestibular and auditory symptoms. This prospective study demonstrates that their prevalence and severity are higher than reported previously. This symptom set demonstrates excellent internal consistency and will serve as a foundation toward developing a disease-specific patient-reported outcome measure for SCDS. LEVEL OF EVIDENCE: NA.

Aggregating the symptoms of superior semicircular canal dehiscence syndrome.

OBJECTIVES/HYPOTHESIS: To aggregate symptoms reported by patients with superior canal dehiscence syndrome (SCDS) and to develop an evidence-based symptom set by performing a systematic review of the literature. STUDY DESIGN: Database search and critical assessment of research studies. METHODS: Medline and PubMed databases were searched for articles that reported the preoperative symptoms of adult and pediatric patients with unilateral and bilateral SCDS. Articles were excluded if they reported on associated diseases or did not report symptoms. RESULTS: Of the 397 articles retrieved, 66 were retained for quantitative analysis. Among 431 patients with SCDS, 91 symptom terms were reported. After combining synonymous terms, 22 symptoms were derived by consensus. Of the raw total number of reported symptoms, 92.5% can be attributed to five common symptoms: spontaneous dizziness (51%), autophony (42.5%), pressure-induced vertigo (37.4%), hearing loss (39.9%), and sound-induced vertigo (42.7%). CONCLUSIONS: This systematic review of symptoms reported by patients with SCDS identified a 22-item common symptom set. These items can be used to create an evidence-based patient-reported outcome measure to evaluate health-related quality of life in SCDS. Laryngoscope, 1932-1938, 2018.