Nueva causa de vértigo estructural: la dehiscencia del canal semicircular superior / A new cause of structural vertigo: superior semicircular canal dehiscence

Resumen. La anamnesis del vértigo debe adaptarse a los conocimientos actuales. En 1998 se describió una nueva causa devértigo asociado a una anomalía estructural, que es la dehiscencia del canal semicircular superior. Ésta causa alteraciones vestibulares y auditivas, frecuentemente asociadas, y una anamnesis bien dirigida permite sospechar el diagnóstico: el sujeto afectado puede sufrir vértigo desencadenado por sonidos intensos (fenómeno de Tullio) y por cambios de presión en el oído o en el espacio intracraneal, con ocasión de maniobras de Valsalva o al presionar sobre el trago del oído (signo de Hennebert). No es infrecuente que el sujeto padezca un desequilibrio crónico empeorado con dichos desencadenantes. Un síntoma auditivo frecuente de la dehiscencia de canal semicircular superior es la autofonía en el oído dehiscente, asociado a una hipoacusia de su transmisión. En este artículo se exponen las preguntas que deben incluirse en la anamnesis del vértigo a fin de evaluar la presencia de estas dehiscencias. También se abordan los procedimientos diagnósticos adecuados para confirmarla. La dehiscencia del canal semicircular superior tiene una solución quirúrgica satisfactoria (AU)

Summary. The medical history of vertigo must be updated to accommodate current knowledge. In 1998 a new cause of vertigo associated with a structural anomaly was reported: superior semicircular canal dehiscence. This condition causes vestibular and auditory disorders, which are frequently associated, and a well-directed medical history allows a suspected diagnosis to be reached: the subject may suffer from vertigo triggered by loud sounds (Tullio’s phenomenon) and by changes in pressure within the ear or in the intracranial space, when Valsalva’s manoeuvres are performed or on pressing on the tragus (Hennebert’s sign). It is not uncommon for subjects to suffer from a chronic imbalance that is exacerbated by the aforementioned precipitating factors. One frequent auditory symptom of superior semicircular canal dehiscence is autophony in the dehiscent ear, associated with hypoacusis of its transmission. This article outlines the questions that must be included in the medical history of vertigo in order to determine whether these dehiscences are present or not. The diagnostic procedures that are best suited to confirming it are also addressed. Superior semicircular canal dehiscence can be resolved satisfactorily by surgery (AU)

[A new cause of structural vertigo: superior semicircular canal dehiscence]. / Nueva causa de vértigo estructural: la dehiscencia del canal semicircular superior.

The medical history of vertigo must be updated to accommodate current knowledge. In 1998 a new cause of vertigo associated with a structural anomaly was reported: superior semicircular canal dehiscence. This condition causes vestibular and auditory disorders, which are frequently associated, and a well-directed medical history allows a suspected diagnosis to be reached: the subject may suffer from vertigo triggered by loud sounds (Tullio's phenomenon) and by changes in pressure within the ear or in the intracranial space, when Valsalva's manoeuvres are performed or on pressing on the tragus (Hennebert's sign). It is not uncommon for subjects to suffer from a chronic imbalance that is exacerbated by the aforementioned precipitating factors. One frequent auditory symptom of superior semicircular canal dehiscence is autophony in the dehiscent ear, associated with hypoacusis of its transmission. This article outlines the questions that must be included in the medical history of vertigo in order to determine whether these dehiscences are present or not. The diagnostic procedures that are best suited to confirming it are also addressed. Superior semicircular canal dehiscence can be resolved satisfactorily by surgery.