Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases

Abstract Objective Different procedures have been described to treat superior canal dehiscence. The present study aims to describe the results obtained with middle fossa approach, transmastoid approach, and round window reinforcement in a large series of patients. Methods and Design In this single‐c...

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Main Authors: Pauline Nieto, Yohan Gallois, Charles‐Edouard Molinier, Olivier Deguine, Mathieu Marx
Format: Article
Language:English
Published: Wiley 2021-12-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.684
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author Pauline Nieto
Yohan Gallois
Charles‐Edouard Molinier
Olivier Deguine
Mathieu Marx
author_facet Pauline Nieto
Yohan Gallois
Charles‐Edouard Molinier
Olivier Deguine
Mathieu Marx
author_sort Pauline Nieto
collection DOAJ
description Abstract Objective Different procedures have been described to treat superior canal dehiscence. The present study aims to describe the results obtained with middle fossa approach, transmastoid approach, and round window reinforcement in a large series of patients. Methods and Design In this single‐center retrospective study, we report the results of the procedures performed between 2006 and 2019 using the three main surgical approaches, middle fossa approach (MFA), transmastoid approach (TMA), and round window reinforcement (RWR). The outcome on cardinal cochlear and vestibular symptoms, audiometric results, and changes in cervical vestibular evoked myogenic potentials (cVEMPs) were analyzed. The patients were also interviewed 12 months to 13 years post‐treatment to establish their overall satisfaction following surgery. Results Sixty‐three patients were divided into three groups: 42 MFA; 12 RWR; 9 TMA. Postsurgical control rates exceeded 80% for the majority of symptoms in the MFA and TMA groups, and ranged from 11.1% to 83.3% for the RWR group. Over 90% of MFA or TMA patients and 60% of the RWR cohort were satisfied overall with their treatment. Hearing thresholds were intact following surgery in the MFA and TMA groups. There was one case of profound postoperative deafness in the RWR group. Conclusion MFA and TMA are both safe and effective techniques in the treatment of disabling SSCD. Since MFA is the more invasive technique, we suggest that TMA should be proposed as first‐line treatment, temporal bone anatomy permitting. RWR outcomes are more variable in term of symptomatic control, and this option could be offered to patients at risk under general anesthesia. Level of evidence Level 4 evidence.
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spelling doaj.art-d35f2dda011a4cad932d576a39113c372022-12-21T23:17:19ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-12-01661414142010.1002/lio2.684Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 casesPauline Nieto0Yohan Gallois1Charles‐Edouard Molinier2Olivier Deguine3Mathieu Marx4Service d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse FranceService d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse FranceService d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse FranceService d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse FranceService d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse FranceAbstract Objective Different procedures have been described to treat superior canal dehiscence. The present study aims to describe the results obtained with middle fossa approach, transmastoid approach, and round window reinforcement in a large series of patients. Methods and Design In this single‐center retrospective study, we report the results of the procedures performed between 2006 and 2019 using the three main surgical approaches, middle fossa approach (MFA), transmastoid approach (TMA), and round window reinforcement (RWR). The outcome on cardinal cochlear and vestibular symptoms, audiometric results, and changes in cervical vestibular evoked myogenic potentials (cVEMPs) were analyzed. The patients were also interviewed 12 months to 13 years post‐treatment to establish their overall satisfaction following surgery. Results Sixty‐three patients were divided into three groups: 42 MFA; 12 RWR; 9 TMA. Postsurgical control rates exceeded 80% for the majority of symptoms in the MFA and TMA groups, and ranged from 11.1% to 83.3% for the RWR group. Over 90% of MFA or TMA patients and 60% of the RWR cohort were satisfied overall with their treatment. Hearing thresholds were intact following surgery in the MFA and TMA groups. There was one case of profound postoperative deafness in the RWR group. Conclusion MFA and TMA are both safe and effective techniques in the treatment of disabling SSCD. Since MFA is the more invasive technique, we suggest that TMA should be proposed as first‐line treatment, temporal bone anatomy permitting. RWR outcomes are more variable in term of symptomatic control, and this option could be offered to patients at risk under general anesthesia. Level of evidence Level 4 evidence.https://doi.org/10.1002/lio2.684hearing losssuperior canal dehiscencevertigo
spellingShingle Pauline Nieto
Yohan Gallois
Charles‐Edouard Molinier
Olivier Deguine
Mathieu Marx
Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
Laryngoscope Investigative Otolaryngology
hearing loss
superior canal dehiscence
vertigo
title Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
title_full Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
title_fullStr Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
title_full_unstemmed Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
title_short Surgical treatments of superior semicircular canal dehiscence: A single‐centre experience in 63 cases
title_sort surgical treatments of superior semicircular canal dehiscence a single centre experience in 63 cases
topic hearing loss
superior canal dehiscence
vertigo
url https://doi.org/10.1002/lio2.684
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