Superior semicircular canal dehiscence syndrome: Successful treatment with repair of the middle fossa floor: Technical case report

Eric C. Peterson, Daniel A. Lazar, Andrew N. Nemecek, Larry Duckert, Robert Rostomily

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

OBJECTIVE: Superior semicircular canal dehiscence syndrome has recently been reported as a cause of pressure-or sound-induced oscillopsia (Tullio phenomenon). We report the presentation and successful treatment of 3 patients with superior semicircular dehiscence syndrome by a joint neurosurgical/neuro- otology team. CLINICAL PRESENTATION: Patient 1 is a 37-year-old man who presented with complaints of disequilibrium, fullness in the left ear, hearing loss, and oscillopsia when pressure was applied to the left external auditory canal. Patient 2 is a 46-year-old man who presented with complaints of disequilibrium, fullness in the left ear, and blurred vision associated with heavy lifting or straining. On examination, pneumatic otoscopy produced a sense of motion. Patient 3 is a 29-year-old woman who presented with chronic disequilibrium that resulted in frequent falls. She had a positive fistula test on the left, and vertical nystagmus was elicited when pressure was applied to the left ear. In each patient, high-resolution computed tomographic scanning through the temporal bone revealed dehiscence of the superior semicircular canal on the symptomatic side. INTERVENTION: In all 3 cases, a subtemporal, extradural approach was performed with repair of the middle fossa floor using calcium phosphate BoneSource (Howmedica Leibinger, Inc., Dallas, TX). All patients recovered well, with resolution of their symptoms. CONCLUSION: Superior semicircular canal dehiscence syndrome is a cause of disequilibrium associated with sound or pressure stimuli. The workup includes a detailed history, electronystagmography including Valsalva maneuvers, and a high-resolution computed tomographic scan though the temporal bone. An extradural repair of the middle fossa floor with BoneSource can successfully treat this condition.

Original languageEnglish (US)
Pages (from-to)1207-1208
Number of pages2
JournalNeurosurgery
Volume63
Issue number6
StatePublished - Dec 1 2008

Keywords

  • Hennebert's sign
  • Nystagmus
  • Oscillopsia
  • Superior semicircular canal
  • Temporal bone
  • Tullio phenomenon

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Peterson, E. C., Lazar, D. A., Nemecek, A. N., Duckert, L., & Rostomily, R. (2008). Superior semicircular canal dehiscence syndrome: Successful treatment with repair of the middle fossa floor: Technical case report. Neurosurgery, 63(6), 1207-1208.