Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea

Rizk, Habib G.; Hatch, Jonathan L.; Stevens, Shawn M.; Lambert, Paul R.; Meyer, Ted A.

doi:10.1177/0194599816651261

Cited by 27 publications

(47 citation statements)

References 44 publications

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“…Six (12.5%) patients who underwent a middle fossa approach had concomitant superior semicircular canal dehiscence. This is not surprising, because both superior canal dehiscence and spontaneous CSF fistula are characterized by a thin tegmen . Nelson et al demonstrated patients with spontaneous CSF fistula have thinner temporal bone squamosa than a control group of patients who underwent cochlear implantation .…”

Section: Discussionmentioning

confidence: 99%

“…This is not surprising, because both superior canal dehiscence and spontaneous CSF fistula are characterized by a thin tegmen. 36 Nelson et al demonstrated patients with spontaneous CSF fistula have thinner temporal bone squamosa than a control group of patients who underwent cochlear implantation. 22 Whyte et al showed a similar relationship of a thin tegmen in patients with superior canal dehiscence.…”

Section: Superior Canal Dehiscencementioning

confidence: 99%

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Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

2018

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Section: Discussionmentioning

confidence: 99%

Section: Superior Canal Dehiscencementioning

confidence: 99%

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

2018

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“…The leading hypothesis suggests that chronic resorption of bone occurs at points where overpressurized dura, cerebral venous sinuses, and/or arachnoid granulations contact the skull base (Fig. ) . Bony attenuation is thought to eventually result in dehiscent communications between the cranial vault, middle ear, inner ear, and/or sinonasal tract.…”

Section: Specific Roles For the Otolaryngologistmentioning

confidence: 99%

“…Common locations for dehiscence include the lateral recess of sphenoid sinus, cribriform plate, tegmen tympani (overlying the ossicular chain), and otic capsule bone over the superior semicircular canal. This process may be expedited, or possibly congenital, in patients with low and/or thin skull bases (especially superior canal dehiscence syndrome [SCDS] patients) . Although a rapidly expanding body of literature has been devoted to this phenomenon over the past 2 decades, objective links between ICP, LPOP, and skull base thickness are currently lacking …”

Section: Specific Roles For the Otolaryngologistmentioning

confidence: 99%

“…5). [8][9][10][77][78][79] Bony attenuation is thought to eventually result in dehiscent communications between the cranial vault, middle ear, inner ear, and/or sinonasal tract. Common locations for dehiscence include the lateral recess of sphenoid sinus, cribriform plate, tegmen tympani (overlying the ossicular chain), and otic capsule bone over the superior semicircular canal.…”

Section: Specific Roles For the Otolaryngologistmentioning

confidence: 99%

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Idiopathic intracranial hypertension: Contemporary review and implications for the otolaryngologist

et al. 2017

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Objectives: 1) Review controversies pertaining to the pathophysiology, diagnosis, and treatment of idiopathic intracranial hypertension. 2) Discuss the evolving role of otolaryngologists in managing this disease and related disorders.Data Sources: Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition.Methods: A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele. Articles were included at the discretion of the authors based on novel and/or historical contributions to the literature.Results: The incidence of idiopathic intracranial hypertension is increasing along with the obesity epidemic. Undiagnosed patients may present to otolaryngologists with pulsatile tinnitus, dizziness, sleep apnea, and spontaneous cerebrospinal fluid leaks. Although diagnosis is predicated upon imaging findings and lumbar puncture, radiographic signs including empty sella, optic nerve dilation, and globe flattening may suggest the diagnosis. The most effective intervention is weight loss combined with acetazolamide. Surgery is reserved for severe or refractory symptoms and can be highly morbid. Otolaryngologists are increasingly responsible for managing a number of secondary disorders including cerebrospinal fluid rhinorrhea and otorrhea. Failure to manage intracranial hypertension may lead to adverse surgical outcomes.Conclusions: The knowledge base for idiopathic intracranial hypertension has greatly expanded over the past 25 years. This disease is associated with a number of conditions directly relevant to otolaryngologists. A keen understanding of this disorder and its management may optimize outcomes in a growing number of patients.

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Traumatic Events Preceding the Development of Superior Canal Dehiscence Syndrome

Formeister,

Krishnan,

Schoo

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo describe the features of antecedent head trauma in patients with superior canal dehiscence syndrome (SCDS).Study DesignCross‐sectional survey.SettingTertiary referral center.MethodsAn online survey was sent to 450 adult patients who underwent surgical repair for SCDS patients asking questions about the nature of internal or external traumatic events preceding symptoms.ResultsOne‐hundred and thirty‐six patients (avg. age, 51.9 years, 62.8% female) completed the survey, of which 61 (44.9%) described either preceding external head trauma (n = 35, 26%), preceding internal pressure event (n = 33, 25%), or both (8, 6%). Of those endorsing external trauma, 22 (63%) described a singular event (head hit by object (n = 8); head hit ground (n = 5); motor vehicle accident (n = 4); assault (n = 2); other (n = 3). One‐third experienced loss of consciousness because of the trauma. For those describing internal pressure events (n = 33), the most common events were heavy physical exertion (9, 27%); pressure changes while flying (6, 18%); coughing, nose blowing with illness (5, 15%); childbirth (5, 15%); and self contained underwater breathing apparatus diving events (3, 9%). The interval between trauma and onset of symptoms averaged 5.6 years (SD, 10.7 years). One‐third (n = 19) described onset of symptoms immediately after the external trauma or internal pressure event. Symptoms began on the side ipsilateral to the trauma in 91%. Sound‐ and pressure‐induced vertigo/oscillopsia developed more commonly after external trauma versus internal pressure events (68% and 61% vs 44% and 32%, respectively).ConclusionTrauma or internal pressure‐related events precede SCDS symptoms in nearly half of cases, with roughly half of preceding events being external.

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Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea

Abstract: Patients with SSCD have a marked thinning of the lateral skull base, more so than patients with spontaneous CSF otorrhea and control groups with different BMIs. Skull base attenuation in SSCD patients did not correlate with BMI.

Cited by 27 publications

References 44 publications

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone

Idiopathic intracranial hypertension: Contemporary review and implications for the otolaryngologist

Traumatic Events Preceding the Development of Superior Canal Dehiscence Syndrome

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