Canal Plane Dynamic Visual Acuity in Superior Canal Dehiscence

Janky, Kristen L.; Zúñiga, M. Geraldine; Ward, Bryan K.; Carey, John P.; Schubert, Michael C.

doi:10.1097/mao.0000000000000336

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…In multiple regression analysis, we found an age-related decline in DVA. These results are corroborated by smaller studies that report age-related effects on DVA ( 4 , 12 , 13 ) and VOR function, particularly for higher velocities of head rotation ( 12 , 14 – 18 ). In patients age 18–89, Paige et al demonstrated age-related changes in VOR phase (timing relationship between head and eye velocity) and declining VOR responses during high-amplitude and high-velocity sinusoidal rotations ( 19 ).…”

Section: Discussionsupporting

confidence: 70%

Normative Scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85â€‰Years

Beaumont

Rine

et al. 2014

Front. Neurol.

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As part of the National Institutes of Health Toolbox initiative, a computerized test of dynamic visual acuity (cDVA) was developed and validated as an easy-to-administer, cost- and time-efficient test of vestibular and visual function. To establish normative reference values, 3,992 individuals, aged 3–85 years, without vestibular pathology underwent cDVA testing at multiple clinical research testing facilities across the United States. Test scores were stratified by sociodemographic characteristics. cDVA was worse in males (p < 0.001) and those subjects 50 years or older, while there was no difference in dynamic visual acuity across age groups binned from 3 to 49 years. Furthermore, we used these normative cDVA data as a criterion reference to compare both the long (validated) and short versions of the test. Both versions can distinguish between those with and without vestibular pathology (p = 0.0002 long; p = 0.0025 short). The intraclass correlation coefficient between long- and short-cDVA tests was 0.86.

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Section: Discussionsupporting

confidence: 70%

Normative Scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85â€‰Years

Beaumont

Rine

et al. 2014

Front. Neurol.

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“…SSCC dehiscence can be a debilitating disease causing physical, functional, and emotional distress (5,6,34,35). Classically, surgical plugging of the dehiscent superior canal was thought to leave it irreversibly dysfunctional (6,36,37). However, Sadeghi et al (37) demonstrated that VOR responses could reach an average gain around 0.5 in the plugged SSCC in their in vivo animal studies.…”

Section: Discussionmentioning

confidence: 99%

Video Head Impulse Test Demonstrates a Residual Function after Plugging of Dehiscent Superior Semicircular Canal

Renteria

Elblidi²,

Al-Tamami³

et al. 2023

Otol Neurotol

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ObjectivePlugging a symptomatic dehiscent superior semicircular canal (SSCC) often leads to a nonfunctional postoperative canal. However, in some instances, a residual function has been described. This study attempts to describe what factors may lead to such residual function.Study designRetrospective study.SettingTertiary referral center.PatientsThirty-five patients with confirmed SSCC dehiscence.InterventionVideo head impulse test was conducted pre- and postoperatively to assess any difference in the function of the SSCC.Main Outcome measuresMean gain and pathological saccades were recorded according to well-established thresholds along with dehiscence length and location to evaluate any associations to residual canal function.ResultsWhen comparing preoperative to postoperative SSCC abnormal gains, a significant increase was observed after plugging (p = 0.023). This also held true when abnormal gain and pathologic saccades were taken together (p < 0.001). Interestingly, 55.3% of patients were observed to remain with a residual SSCC function 4 months postoperatively even with a clinical improvement. Of these, 47.6% had normal gain with pathologic saccades, 38.1% had an abnormal gain without pathologic saccades, and 14.3% had normal gain without pathologic saccades (normal function). Preoperatively, SSCC abnormal gain was associated with a larger dehiscence length mean (p = 0.002). Anterosuperior located dehiscences were also associated with a larger dehiscence length mean (p = 0.037). A residual SSCC function after plugging was associated with a shorter dehiscence length regardless of location (p = 0.058).ConclusionDehiscence length and location may be useful in predicting disease symptomatology preoperatively and canals function recovery after plugging. These factors could be used as indicators for preoperative counseling and long-term management.

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“…This corresponds with elimination of the third mobile window, as has been demonstrated by the normalization of cervical VEMP thresholds ( 96 ), the ocular VEMP amplitudes ( 96 ), the elevated SP to AP ratio ( 86 , 89 ), and the low-frequency air-bone gap ( 97 ). After surgical plugging, patients have expected reduction in the function of the superior semicircular canal ( 7 , 98 ). About one-third of patients have a temporary pan-labyrinthine hypofunction ( 99 ), and approximately 15% have plugging material that also impacts function of the posterior semicircular canal ( 7 ).…”

Section: Treatmentmentioning

confidence: 99%

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

2017

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Superior semicircular canal dehiscence syndrome was first reported by Lloyd Minor and colleagues in 1998. Patients with a dehiscence in the bone overlying the superior semicircular canal experience symptoms of pressure or sound-induced vertigo, bone conduction hyperacusis, and pulsatile tinnitus. The initial series of patients were diagnosed based on common symptoms, a physical examination finding of eye movements in the plane of the superior semicircular canal when ear canal pressure or loud tones were applied to the ear, and high-resolution computed tomography imaging demonstrating a dehiscence in the bone over the superior semicircular canal. Research productivity directed at understanding better methods for diagnosing and treating this condition has substantially increased over the last two decades. We now have a sound understanding of the pathophysiology of third mobile window syndromes, higher resolution imaging protocols, and several sensitive and specific diagnostic tests. Furthermore, we have a treatment (surgical occlusion of the superior semicircular canal) that has demonstrated efficacy. This review will highlight some of the fundamental insights gained in SCDS, propose diagnostic criteria, and discuss future research directions.

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Canal Plane Dynamic Visual Acuity in Superior Canal Dehiscence

Cited by 7 publications

References 23 publications

Normative Scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85â€‰Years

Normative Scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85â€‰Years

Video Head Impulse Test Demonstrates a Residual Function after Plugging of Dehiscent Superior Semicircular Canal

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

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