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Otol Neurotol. 2012 Jul;33(5):824-31. doi: 10.1097/MAO.0b013e3182544c9e.

Clinical factors associated with prolonged recovery after superior canal dehiscence surgery.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center, Utrecht, The Netherlands.

Abstract

OBJECTIVE:

To identify clinical factors associated with prolonged recovery after superior canal dehiscence surgery.

STUDY DESIGN:

Retrospective review.

SETTING:

Tertiary care academic medical center.

PATIENTS:

Thirty-three patients that underwent surgery for SCDS were identified from a database of 140 patients diagnosed with SCD (2000-2010) at the Massachusetts Eye and Ear Infirmary (U.S.A.). The diagnosis of SCDS was based on clinical signs and symptoms, audiometric and vestibular testing and high-resolution temporal bone computed tomography.

INTERVENTION:

For the primary repair, the superior canal was plugged in 31 patients through a middle fossa craniotomy approach and in 1 patient through a transmastoid approach. In 1 patient, the SCD was resurfaced through a middle fossa craniotomy approach.

MAIN OUTCOME MEASURES:

Postoperative clinical signs and symptoms and factors that may influence duration of disequilibrium after surgery.

RESULTS:

Thirty-three patients (15-71 yr; mean, 43 yr) underwent surgery for SCDS on 35 ears (2 bilateral). Mean follow-up was 28.7 months (range, 3 mo to 10 yr); 33 of 33 (100%) patients experienced initial improvement of the chief complaint. Three patients required revision surgery, improving symptoms in 2 patients. Six patients had dizziness lasting more than 4 months postoperatively, and all had bilateral SCD, migraines, and a dehiscence of 3 mm or greater.

CONCLUSION:

Surgical plugging of SCD is an effective management option to provide long-term improvement of the chief complaint in SCDS patients. Patients with bilateral SCD, a history of migraines, and larger defects may be at risk of prolonged recovery and should be appropriately counseled.

PMID:
22664897
DOI:
10.1097/MAO.0b013e3182544c9e
[Indexed for MEDLINE]

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