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Otol Neurotol. 2012 Jan;33(1):72-7. doi: 10.1097/MAO.0b013e31823c9182.

Second-side surgery in superior canal dehiscence syndrome.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

Abstract

OBJECTIVE:

Bilateral superior canal (SC) dehiscence syndrome poses a challenge because bilateral SC dehiscence (SCD) plugging might be expected to result in oscillopsia and disability. Our aims were as follows: 1) to evaluate which symptoms prompted patients with bilateral SCD syndrome (SCDS) to seek second-side surgery, and 2) to determine the prevalence of disabling imbalance and oscillopsia after bilateral SC plugging.

STUDY DESIGN:

Prospective observational study.

SETTING:

Tertiary referral center.

PATIENTS:

Five patients with bilateral SCDS based on history, audiometric and physiologic testing, and computed tomographic findings. This includes all of our patients who have had second-side plugging surgery to date.

INTERVENTION(S):

Bilateral sequential middle fossa craniotomy and plugging of SCs.

MAIN OUTCOME MEASURE(S):

Cochleovestibular symptoms, cervical and ocular vestibular-evoked myogenic potential testing, dizziness handicap inventory, short-form 36 Health Survey, dynamic visual acuity testing.

RESULTS:

The most common symptoms prompting second-side surgery were sound- and pressure-induced vertigo and autophony. Three of the 5 patients reported that symptoms shifted to the contralateral ear immediately after plugging the first side, whereas in 2 patients, contralateral symptoms developed several years after the first SC plugging. Two of 4 patients experienced ongoing oscillopsia after bilateral SCDS surgery; however, all patients reported relief from their SCD symptoms and were glad that they had pursued bilateral surgery.

CONCLUSION:

In patients with bilateral SCDS, sound- and pressure-induced vertigo most commonly prompted second-side surgery. Despite some degree of oscillopsia after bilateral SCDS surgery, patients were very satisfied with second-side surgery, given their relief from other SCDS symptoms.

PMID:
22158019
PMCID:
PMC4082242
DOI:
10.1097/MAO.0b013e31823c9182
[Indexed for MEDLINE]
Free PMC Article

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