Surgical treatments of superior semicircular canal dehiscence: A single-centre experience in 63 cases

[摘要] Objective: Different procedures have been described to treat superior canal dehiscence. The present study aims to describe the results obtained with middle fossaapproach, transmastoid approach, and round window reinforcement in a large seriesof patients.Methods and Design: In this single-center retrospective study, we report the resultsof the procedures performed between 2006 and 2019 using the three main surgicalapproaches, middle fossa approach (MFA), transmastoid approach (TMA), and roundwindow reinforcement (RWR). The outcome on cardinal cochlear and vestibularsymptoms, audiometric results, and changes in cervical vestibular evoked myogenicpotentials (cVEMPs) were analyzed. The patients were also interviewed 12 monthsto 13 years post-treatment to establish their overall satisfaction following surgery.Results: Sixty-three patients were divided into three groups: 42 MFA; 12 RWR;9 TMA. Postsurgical control rates exceeded 80% for the majority of symptoms in theMFA and TMA groups, and ranged from 11.1% to 83.3% for the RWR group. Over90% of MFA or TMA patients and 60% of the RWR cohort were satisfied overall withtheir treatment. Hearing thresholds were intact following surgery in the MFA andTMA groups. There was one case of profound postoperative deafness in the RWRgroup.Conclusion: MFA and TMA are both safe and effective techniques in the treatmentof disabling SSCD. Since MFA is the more invasive technique, we suggest that TMAshould be proposed as first-line treatment, temporal bone anatomy permitting. RWRoutcomes are more variable in term of symptomatic control, and this option could beoffered to patients at risk under general anesthesia.

[学科分类] 环境科学（综合）

[关键词] hearing loss;superior canal dehiscence;vertigo