Near-dehiscence: clinical findings in patients with thin bone over the superior semicircular canal.
Otol Neurotol
; 34(8): 1421-8, 2013 Oct.
Article
en En
| MEDLINE
| ID: mdl-23644303
ABSTRACT
OBJECTIVE:
To determine whether patients with thin bone over the superior semicircular canal can develop signs or symptoms of superior canal dehiscence syndrome (SCDS). STUDYDESIGN:
Retrospective case series.SETTING:
Tertiary referral center. PATIENTS All patients from our institution found to have thin but not frankly dehiscent bone over the superior canal despite symptoms and signs of SCDS. MAIN OUTCOMEMEASURES:
Preoperative CT imaging, symptoms, audiometry, vestibular evoked myogenic potentials (VEMP), and intraoperative electrocochleography (ECochG) results were reviewed. Symptoms were assessed at least 1 month postoperatively in all patients, and postoperative physiologic data are presented when available.RESULTS:
Ten patients (11 ears) had thin bone over the superior semicircular canal at surgery. All presented with autophony or sound- and/or pressure-induced vertigo, in addition to at least 1 physiologic measure consistent with SCDS. CT imaging was read as showing either dehiscence (36%) or marked thinning of bone overlying the affected canal (64%). Preoperative median low-frequency air-bone gap (ABG) was elevated (10.9 dB; interquartile range [IQR], 8.8-12.5), with 4 patients demonstrating negative bone conduction thresholds. Patients had elevated oVEMP amplitude (median, 20.7; IQR, 6.7-22.1) µV and ECochG SP/AP ratios (median, 0.59; IQR, 0.54-0.67). Postoperative ABG and SP/AP ratio decreased significantly compared with preoperative values (p < 0.05), and all patients reported symptomatic improvement.CONCLUSION:
Symptoms typical of SCDS can occur in cases with thin but not dehiscent bone. Surgical plugging or resurfacing can reduce symptoms in such cases.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Canales Semicirculares
/
Enfermedades del Laberinto
Tipo de estudio:
Diagnostic_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Otol Neurotol
Asunto de la revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos