Outcomes and complications in superior semicircular canal dehiscence surgery: A systematic review

Gioacchini, Federico Maria; Alicandri‐Ciufelli, Matteo; Kaleci, Shaniko; Scarpa, Aldo; Cassandro, Ettore; Re, Massimo

doi:10.1002/lary.25662

Cited by 73 publications

(55 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Two other cases who underwent surgery for SSCCD were found to have postoperative significant deterioration in BC PTA without common denominator for these cases. A higher rate of postoperative SNHL was demonstrated with plugging the SSCC through the MFA and with plugging the SSCC in general compared to capping . The use of bone pâté was associated with lower rates of postoperative HL in SSCCD surgeries …”

Section: Discussionmentioning

confidence: 89%

The pattern of hearing outcome following surgery of the semicircular canals

Wolfovitz

Grobman

Babcock

et al. 2018

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objective To analyze demographic, clinical, surgical, and audiometric factors that may affect hearing outcome following surgery for the semicircular canals (SCC). Method This is a retrospective case review of adults who underwent surgeries for superior SCC (SSCC), lateral SCC (LSCC), or posterior SCC (PSCC) and whose data were extracted and analyzed for factors affecting the hearing outcome in these procedures. Results Thirteen patients underwent surgery for SSCC, seven cases for the LSCC, one for the PSCC, and one case of combined PSCC/SSCC surgery. The mean age was 49.8 ± 12 years (21–66). There was no difference between the preoperative and postoperative pure tone average (PTA) thresholds at 0.5–3 kHz. Higher thresholds were noted at 4, 6, and 8 kHz postoperatively. Deterioration (>10 dB) in the bone‐conduction (BC) PTA was demonstrated in 3 of 22 (13.6%) cases with no significant difference in the demographic, clinical, surgical, and preoperative audiometric parameters relative to the cases without PTA BC change. A significantly larger difference in PTA BC (pre‐ vs. postoperative) was seen for males. Small effect size was noted for Air conduction (AC) PTA in males, and moderate effect size for Word Recognition Score (WRS) in surgery for the LSCC compare to SSCC. Conclusions SCC surgeries carry a relatively low risk of deterioration in PTA BC. High frequency thresholds should also be included in postoperative hearing outcome assessment. Cases of LSCC for intractable Meniere's disease and surgery in males carry higher risk of poor postoperative hearing outcomes. Level of Evidence: 4

show abstract

Section: Discussionmentioning

confidence: 89%

The pattern of hearing outcome following surgery of the semicircular canals

Wolfovitz

Grobman

Babcock

et al. 2018

Laryngoscope Investig Oto

View full text Add to dashboard Cite

show abstract

“…The use of several materials including bone pâté, perichondrium, cartilage, fascia, cortical bone, and bone substitutes such as hydroxyapatite has been described . We have previously reported on using a construct composed of a fascia underlay and tragal cartilage overlay, held together by Tisseel (Baxter Healthcare) . Most of the patients included in this study underwent resurfacing with a cartilage overlay and an underlay of pericondrium or fascia, supplemented with bone pâté or Tisseel (Baxter Healthcare).…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have examined the success of resurfacing in the treatment of SSCD; these have shown mixed results. In a recent meta‐analysis by Giocchini et al, no significant differences in surgical success, defined as complete or partial disappearance of symptoms, was found between resurfacing or plugging. However, a meta‐analysis by Vlastarakos et al determined that resurfacing had a success rate of 50% as compared with 97% for plugging; here, success was defined as symptom resolution.…”

Section: Introductionmentioning

confidence: 91%

Outcomes of transmastoid resurfacing for superior canal dehiscence using a cartilage overlay technique

2019

View full text Add to dashboard Cite

Objective Superior semicircular canal dehiscence is a well‐described syndrome with potentially debilitating symptoms. We report on the audiologic and long‐term symptom outcomes of 10 patients (12 ears) undergoing a cartilage overlay transmastoid resurfacing technique. Methods Retrospective chart review and cross‐sectional outcomes recall survey were used. A mailed questionnaire quantifying the effect of surgery on symptom severity and patient satisfaction were used. Nonlinear regression curves of pre‐/postoperative air and bone pure‐tone audiometric data were used to evaluate postoperative changes in hearing. Surgical failure was defined as requiring revision surgery, and rates were estimated over time using a Kaplan‐Meier analysis. Results Most patients reported improved symptoms postoperatively and were satisfied overall with the surgical outcomes. However, four of 12 ears (33%) had a second (revision) surgery before achieving these results. Postoperatively, hearing through air and bone conduction tended to decrease at frequencies greater than 2500 Hz. The chance of avoiding a re‐operation at 36 months (and up to 120 months) was estimated to be 57.1% (95% confidence interval [confidence interval]: 100%, 32.6%). The most common surgical complication was intraoperative cerebrospinal fluid (CSF) leak, encountered exclusively during dural elevation, seen in four of 12 ears (33%). Conclusion Although subjectively successful at reducing symptoms, in our small sample this surgical approach did not provide a long‐term stable repair and was frequently associated with intraoperative CSF leak. Offering transmastoid resurfacing to patients should involve a detailed discussion on the potential for revision surgery and risks of diminished hearing and CSF leak. Level of Evidence 4 Laryngoscope, 129:2164–2169, 2019

show abstract

“…Háskerputölvusneiðmyndir eru jafnan gerðar til að sýna fram á beineyðinguna. 10 Önnur greiningarleið er svokallað VEMP-próf (Vestibular Evoked Myogenic Potential). Það er próf sem gengur út á að hljóðörvun er gefin í eyrað sem prófað er og síðan er vöðvavirknin í hliðvendivöðva (sternocleidomastoideus muscle) sömu hliðar maeld.…”

Section: Umraeðaunclassified

“…2,10 Sjaldgaeft er að sjúklingar greinist með einkennagefandi rof á bogagöngum. Mögulega stafar það af einkennamyndinni sem er nokkuð sérstök og því að sjúklingar eru ef til vill ekki tilbúnir til að greina frá öllum sínum einkennum.…”

Section: Umraeðaunclassified

Rof á efri bogagöngum – sjúkratilfelli

Baldvinsdóttir¹,

Nardini²,

Ólafsson³

et al. 2016

LBL

View full text Add to dashboard Cite

InngangurBogagöng innra eyrans eru þrjú talsins og mikilvaegur hluti jafnvaegiskerfis líkamans. Rof á efri bogagöngum (superior canal dehiscence) er sjaldgaef orsök heyrnardeyfu og svima.1,2 Fáir hafa greinst á Íslandi. Níu Ís-lendingar hafa farið í aðgerð í laekningatilgangi (apríl 2015). Fjórir fyrstu sjúklinganir sem þurftu aðgerð fóru til Baltimore í Bandaríkjunum. Hinir 5 fóru í aðgerð hér á landi og er hér lýst einu þeirra tilfella. Tilfellið28 ára hraust kona hafði fundið fyrir svima og hellu fyrir vinstra eyra um þriggja mánaða skeið. Sviminn lýsti sér sem sundl (dizziness). Sjónsviðið hreyfðist og virtist við nánari skoðun gera það í takt við hjartslátt-inn. Helst gerðist það þegar höfðinu var snúið langt yfir til annarrar hvorrar hliðarinnar. Einnig varð þessara sjónsviðsáhrifa vart við utanaðkomandi áreiti, svo sem titring. Viðkomandi leitaði til mismunandi laekna sem gerðu ýmsar rannsóknir án þess að greining fengist. Meðal annars var gerð segulómskoðun (magnetic resonance imaging) af höfði til að útiloka meinsemdir og kom sú rannsókn eðlilega út. Við frekari eftirgrennslan kom í ljós að einkennin voru töluvert meiri en sjúklingur-inn hafði í fyrstu látið uppi. Hluti þess var að hún hafði hreinlega ekki áttað sig á að ástandið vaeri svo óeðlilegt sem raun bar vitni. Til að mynda var ljóst að viðkomandi var með talsverða sjálfheyrn (autophony). Það lýsti sér þannig að sjúklingurinn heyrði stöðugt eigin hjartatóna og hreyfingar um hálsliði. Þá heyrðist einnig marrandi hljóð við allar augnhreyfingar. Það var orðið óbaerilegt fyrir sjúklinginn að tala þar sem eigin rödd glumdi í höfðinu.Rof á efri bogagöngum innra eyra (superior canal dehiscence) getur valdið sérstaeðri einkennamynd, það er heyrnardeyfu, svima og sjálfheyrn (autophonia). Haegt er að laekna sjúklinginn með skurðaðgerð. 28 ára hraust kona leitaði til ýmissa laekna um nokkurra mánaða skeið vegna hellu fyrir vinstra eyra, svima og sjálfheyrnar. Einkennin höfðu ágerst. Uppvinnsla leiddi í ljós rof á efri bogagöngum vinstra eyra. Fór sjúklingurinn í aðgerð og löguðust einkennin. Töf getur orðið á greiningunni enda um sjaldgaefan sjúkdóm að raeða. Mikilvaegt er að hafa rof á efri bogagöngum í huga þegar sjúklingar með þessi einkenni leita laeknis. ÁGRIPFór svo að sjúklingnum var beint til sérfraeðings á háls-, nef-og eyrnadeild Landspítala. Fór þar fram ítarleg uppvinnsla. Fólst skoðunin meðal annars í að viðkomandi laeknir setti tónkvísl á sköflungshnyðju (malleolus medialis) sjúklingsins sem heyrði þá greinilega hljóðið frá titrandi tónkvíslinni í vinstra eyra sínu. Heyrnarmaeling sýndi góða heyrn, sjá mynd 1. Því naest var gert Tullio-próf. Í því felst að athuga hvort sjúklingurinn fái augntif (nystagmus) við hávaðaáreiti. Reyndist það vera jákvaett í þessu tilfelli og komu fram baeði talsvert augntif og svimi við prófunina.Greiningin fékkst svo með háskerpu tölvusneið-myndum af klettbeinum (temporal bones) sem sýndu fram á eyðingu beins í efri bogagöngunum, sjá mynd 2. Sjúklingurinn fór í framhaldinu í skurðaðgerð þar sem þétt var með eigi...

show abstract

Outcomes and complications in superior semicircular canal dehiscence surgery: A systematic review

Abstract: NA Laryngoscope, 126:1218-1224, 2016.

Cited by 73 publications

References 27 publications

The pattern of hearing outcome following surgery of the semicircular canals

The pattern of hearing outcome following surgery of the semicircular canals

Outcomes of transmastoid resurfacing for superior canal dehiscence using a cartilage overlay technique

Rof á efri bogagöngum – sjúkratilfelli

Contact Info

Product

Resources

About