Semicircular canal dehiscence among idiopathic intracranial hypertension patients

Idiopathic intracranial hypertension (IIH), is a challenging condition with raised intracranial pressure without any identifiable cause. It's incidence increases due to it's close association with obesity. This pathology has strong relation with tegmental dehiscence and spontaneous cerebrospinal fluid (CSF) leaks. There are reports of tegmental dehiscence, spontaneous CSF leaks ocurring with SSCD. Superior semicircular canal dehiscence is also associated with obesity in the literature. The aim of this study is to determine the incidence of SSCD in IIH patients, to evaluate the audiovestibular findings in IIH patients with SSCD, and to discuss the possible pathogenetic mechanisms causing this co-occurence. Material and Methods: Twenty five consecutive patients diagnosed with IIH in the neurology department between 2016-2018 were evaluated. Ten patients fulfilling the necessary criteria and accepting to participate in this study, were enrolled in the study group. Audiometry, tympanometry, vestibular evoked myogenic potentials (VEMP) tests and high resolution computed tomography (HRCT) imagings were performed. The control group was constituded of 20 age and sex matched patients attended to our clinic with various other complaints, and to whom HRCT was conducted between 2016 and 2018. Results: Among the study group 1 (10%) patient with IIH had SSCD. Two (20%) patients had thinning in the bony canal. None of the patients in the control group had neither radiographic SSCD, nor bony thinning. Patient with SSCD had pathological signs in VEMP. Conclusion: According to our results, though not statistically significant, the incidence of SSCD seems higher in IIH. The incidence of bony thinning also seems more frequent in IIH. However further studies with wide patient series are essential.

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“…Varios other studies reported a radiological incidence between 0,8-12% for SSCD. 7,[13][14][15][16] Our findings correlate with the literature.…”

Section: Discussionsupporting

confidence: 88%

Superior Semicircular Canal Dehiscence in Idiopathic Intracranial Hypertension: Preliminary Report

Çoban¹,

Beyazpinar²,

Kibaroğlu³

et al. 2021

KBB ve BBC Dergisi

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“…The pathogenesis of SSC dehiscence has not been established 25 . Kuo et al have found no association between IIH and the presence of SSC dehiscence 26 . The stability of the bone of the SSC in the current study could be due to limitations in the study and not necessarily true absolute stability of the otic capsule.…”

Section: Discussionmentioning

confidence: 52%

“…25 Kuo et al have found no association between IIH and the presence of SSC dehiscence. 26 The stability of the bone of the SSC in the current study could be due to limitations in the study and not necessarily true absolute stability of the otic capsule. Given the retrospective nature of the study, some of the scans were of less than optimal quality for acquisition of data regarding the thickness of the bone of the SSC.…”

Section: Discussionmentioning

confidence: 82%

Tegmen attenuation in patients with idiopathic intracranial hypertension is progressive

et al. 2020

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Objectives: To prove that temporal bone tegmen attenuation in patients with idiopathic intracranial hypertension (IIH) is progressive. Study Design: Retrospective blind study at a tertiary academic medical center. Methods: Enrolled were medical records of patients with IIH that included at least two sequential computed tomography (CT) scans. The vertical distances between the floor of the middle fossa to the superior and lateral semicircular canals (SSC and LSC, respectively), to the scutum and minimal squama thickness were measured. The same measurements were made in scans of control subjects. The impact of demographics and metabolic variables including opening lumbar puncture (LP) pressure were evaluated. Results: Twenty medical records were enrolled. Median age at diagnosis was 21 years; 16 were females. The median body mass index (BMI) was 32 kg/m 2. Initial LP pressure was 195 mm cerebrospinal fluid (CSF). The median time interval between CT scans was 58 months. A median attenuation of 0.35 mm and 0.25 mm over the right and left LSC and of 0.5 mm and 0.3 mm over the right and left scutum, was found, respectively. The thicknesses of the SSC and squama remained stable. No attenuation was present in controls. The opening pressure on initial LP (median 195 mm CSF), was positively correlated with the degree of tegmen attenuation, but the age at diagnosis and BMI were not. Conclusions: Tegmen attenuation may be progressive in patients with idiopathic increased intracranial pressure and correlated with the opening pressure on LP. Tegmen defects and CSF leak should be looked for in these patients.

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“…25 Whether radiographic superior semicircular canal dehiscence is more common in the setting of increased intracranial pressure remain debatable. 26 According to the prevalence of each of the diseases, the concomitant combination is calculated to be in the range of 150/100 000 of the general population, and probably much higher among revision stapes surgery candidates.…”

Section: Discussionmentioning

confidence: 99%

Superior semicircular canal dehiscence with concomitant otosclerosis—A literature review and case discussion

Ungar

Handzel

Cavel

et al. 2018

Clinical Case Reports

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Semicircular canal dehiscence among idiopathic intracranial hypertension patients

Abstract: 3b. Laryngoscope, 128:1196-1199, 2018.

Cited by 22 publications

References 16 publications

Superior Semicircular Canal Dehiscence in Idiopathic Intracranial Hypertension: Preliminary Report

Superior Semicircular Canal Dehiscence in Idiopathic Intracranial Hypertension: Preliminary Report

Tegmen attenuation in patients with idiopathic intracranial hypertension is progressive

Superior semicircular canal dehiscence with concomitant otosclerosis—A literature review and case discussion

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