Cartilage Cap Occlusion Technique for Dehiscent Superior Semicircular Canals

Lundy, Larry; Zapala, David A.; Moushey, Jamie M.

doi:10.1097/mao.0b013e31822e5b27

Cited by 20 publications

(20 citation statements)

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“…The success rates for the transmastoid approach were assessed in six studies. Of the six studies, three involved plugging, one involved a combination of plugging and resurfacing, and two involved resurfacing alone [i.e., “cartilage cap occlusion” (15)]. Reinforcement of the round window through the ear canal was assessed in one study.…”

Section: Resultsmentioning

confidence: 99%

Heterogeneity in Reported Outcome Measures after Surgery in Superior Canal Dehiscence Syndrome—A Systematic Literature Review

et al. 2017

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BackgroundSuperior canal dehiscence syndrome (SCDS) can be treated surgically in patients with incapacitating symptoms. However, the ideal treatment has not been determined.ObjectivesThis systematic literature review aims to assess available evidence on the comparative effectiveness and risks of different surgical treatments regarding: (1) symptom improvement; (2) objectively measurable auditory and vestibular function; (3) adverse effects, and (4) length of hospitalization.Search method and data sourcesA systematic database search according to PRISMA statement was conducted on Pubmed, Embase, and Cochrane library. In addition, reference lists were searched. No correspondence with the authors was established. The last search was conducted on June 9, 2017.Study eligibility criteriaRetrospective and prospective cohort studies were held applicable under the condition that they investigated the association between a surgical treatment method and the relief of vestibular and/or auditory symptoms. Only studies including quantitative assessment of the pre- to postoperative success rate of a surgical treatment method were included. Case reports, reviews, meta-analysis, and studies not published in English, Dutch, or German were excluded.Data collection and analysisThe first author searched literature and extracted data; the first and last analyzed the data.Main resultsSeventeen studies (354 participants, 367 dehiscences) met the eligibility criteria and were grouped according to surgical approach. Seven combinations of surgical approaches and methods for addressing the dehiscence were identified: plugging, resurfacing, or a combination of both through the middle fossa (middle fossa approach); plugging, resurfacing, or a combination of both through the mastoid (transmastoid approach); round window reinforcement through the ear canal (transcanal approach). Several studies showed high internal validity, but quality was often downgraded due to study design (1). Outcome measures and timing of postsurgical assessment varied among studies, making it unfeasible to pool data to perform a meta-analysis.ConclusionA standardized protocol including outcome measures and timeframes is needed to compare the effectiveness and safety SCDS treatments. It should include symptom severity assessments and changes in vestibular and auditory function before and after treatment.

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Section: Resultsmentioning

confidence: 99%

Heterogeneity in Reported Outcome Measures after Surgery in Superior Canal Dehiscence Syndrome—A Systematic Literature Review

et al. 2017

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“…Although bone dust has been reported to be efficacious for the repair of tegmen defects, it has always been used with another substance (i.e., carbonated calcium phosphate, cartilage, duragen, fascia, muscle, split cranial bone) [2][3][4][5][6][7][8][9]. In contrast, when bone dust has been used alone to repair critical size calvarial gaps it does not ossify clinically [10][11][12] or experimentally [16][17][18].…”

Section: Discussionmentioning

confidence: 98%

“…Regardless of the type of surgical approach and substance used, recurrence of the cerebrospinal fluid leak is uncommon as long as the tegmen is repaired with multiple layers of different materials [1]. One substance that has been used commonly to reconstruct holes in the tegmen is bone dust collected from a high speed burr during the initial mastoidectomy or craniotomy [2][3][4][5][6][7][8][9]. The autologous bone dust then is typically mixed with blood, and/or fibrin glue to form a paste, before it is used to fill the bony defect.…”

Section: Discussionmentioning

confidence: 99%

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Repair of tegmen defect using cranial particulate bone graft

Greene

Poe

2015

American Journal of Otolaryngology

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“…Early feasibility studies on hearing preservation after canal plugging were observed by Parnes and McClure among guinea pigs [Parnes and McClure, 1985]. Among human-beings, the preservation of hearing thresholds has been observed in patients undergoing canal plugging of the posterior canal through the transmastoid approach and the superior canal by the middle cranial fossa approach [Agrawal and Parnes, 2001;Banakis Hartl and Cass, 2018;Beyea et al, 2012;Lundy et al, 2011;Niesten et al, 2013;Powell et al, 2016;Van Haesendonck et al, 2016;Yamauchi et al, 2017] as well as the superior canal by middle cranial fossa approach [Ward et al, 2012]. Generally, surgery has a positive impact of the symptoms of SCDS.…”

Section: Introductionmentioning

confidence: 99%

Hearing Outcomes after Transmastoid Plugging of Superior Canal Dehiscence

Wilms¹,

Ernst²,

Mittmann³

2018

Audiol Neurotol

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Background: Patients with a superior canal dehiscence syndrome display symptoms of the vestibular disorder except that of hearing loss. Therefore, any type of surgery should treat those symptoms without affecting the hearing threshold. The aim of this study was to evaluate the extent to which the hearing threshold has been affected; the evaluation process was carried out by a transmastoid plugging of the superior canal. Another aim was to estimate the risk in loss of hearing due to this surgery. Material and Methods: In a retrospective study, 31 patients with dehiscence of the superior canal, who underwent a transmastoid plugging, were included. Additionally, 8 of them with the clinical symptoms of the Menière’s disease received an endolymphatic sac surgery. A b-c threshold at 0.25, 0.5, 1, 2, and 4 kHz was observed in all patients pre and postoperatively as well as in the long-term follow-up. Results: After a mean interval of 149 days, a change in the b-c threshold of 5.9 dB was detected. After 149 days, in the patient group comprising those who underwent an additional endolymphatic sac surgery, a b-c threshold change of 17.18 dB was detected. Conclusion: The transmastoid plugging of the superior semicircular canal can be performed with an acceptable risk of hearing affection. If the surgery was combined with other techniques, (e.g. endolymphatic sac surgery) then the risk increases.

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Cartilage Cap Occlusion Technique for Dehiscent Superior Semicircular Canals

Abstract: The cartilage cap occlusion technique of dehiscent superior semicircular canals via a transmastoid and tegmen mini-craniotomy approach is a good option for managing symptomatic patients with a dehiscent superior semicircular canal.

Cited by 20 publications

References 16 publications

Heterogeneity in Reported Outcome Measures after Surgery in Superior Canal Dehiscence Syndrome—A Systematic Literature Review

Heterogeneity in Reported Outcome Measures after Surgery in Superior Canal Dehiscence Syndrome—A Systematic Literature Review

Repair of tegmen defect using cranial particulate bone graft

Hearing Outcomes after Transmastoid Plugging of Superior Canal Dehiscence

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