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Am J Otolaryngol. 2014 May-Jun;35(3):286-93. doi: 10.1016/j.amjoto.2014.02.016. Epub 2014 Mar 5.

Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series.

Author information

1
Silverstein Institute, Ear Research Foundation, Sarasota, FL. Electronic address: hsilverste@aol.com.
2
Michigan Ear Institute, Farmington Hills, MI.
3
London Health Sciences Centre, London, Ontario.
4
Boston Children's Hospital, Boston, MA.
5
Saratoga Ear and Sinus Surgery, Saratoga Springs, NY.
6
Silverstein Institute, Ear Research Foundation, Sarasota, FL.

Abstract

PURPOSE:

To evaluate the outcome of round window (RW) tissue reinforcement in the management of superior semicircular canal dehiscence (SSCD).

MATERIALS AND METHODS:

Twenty-two patients with confirmed diagnosis of SSCD by clinical presentation, imaging, and/or testing were included in the study. Six surgeons at four institutions conducted a multicenter chart review of patients treated for symptomatic superior canal dehiscence using RW tissue reinforcement or complete RW occlusion. A transcanal approach was used to reinforce the RW with various types of tissue. Patients completed a novel postoperative survey, grading preoperative and postoperative symptom severity.

RESULTS:

Analysis revealed statistically significant improvement in all symptoms with the exception of hearing loss in 19 patients who underwent RW reinforcement. In contrast, 2 of 3 participants who underwent the alternate treatment of RW niche occlusion experienced worsened symptoms requiring revision surgery.

CONCLUSION:

RW tissue reinforcement may reduce the symptoms associated with SSCD. The reinforcement technique may benefit SSCD patients by reducing the "third window" effect created by a dehiscent semicircular canal. Given its low risks compared to middle cranial fossa or transmastoid canal occlusion, RW reinforcement may prove to be a suitable initial procedure for intractable SSCD. In contrast, complete RW occlusion is not advised.

PMID:
24667055
DOI:
10.1016/j.amjoto.2014.02.016
[Indexed for MEDLINE]

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