Auditory function in patients with surgically treated superior semicircular canal dehiscence

Charles J Limb, John P Carey, Sharmila Srireddy, Lloyd B Minor
Otology & Neurotology 2006, 27 (7): 969-80

OBJECTIVE: To characterize preoperative and postoperative audiologic findings in patients with superior semicircular canal dehiscence syndrome.

STUDY DESIGN: Retrospective case review.

SETTING: Tertiary referral center.

PATIENTS: Patients with documented superior semicircular canal dehiscence syndrome (according to history, vestibular testing, and high-resolution computed tomography imaging) who underwent surgical repair of their dehiscence.

INTERVENTION: Middle fossa craniotomy for superior semicircular canal plugging and/or resurfacing.

MAIN OUTCOME MEASURES: Audiologic testing both before and after surgery with pure-tone threshold measurements of air and bone conduction.

RESULTS: Twenty-nine subjects underwent surgical repair of superior semicircular canal dehiscence. Overall, there were no statistically significant differences by paired t test in hearing before or after surgery, in either air-conduction or bone-conduction thresholds, for 19 patients that had no previous surgical history. At least partial closure of air-bone gap was achieved in five patients. One patient with previous stapes surgery had significantly worse hearing both before and after canal repair compared with those without previous surgery. Two patients who had undergone previous middle fossa surgery with incomplete resolution of symptoms developed sensorineural hearing loss after revision surgery. Previous middle-ear exploration and tympanostomy tube placement did not seem to affect audiologic outcomes. Surgical hearing results did not differ according to method of canal repair (plugging versus resurfacing).

CONCLUSION: Primary middle fossa repair of superior semicircular canal dehiscence is not associated with sensorineural hearing loss and, in some cases, can lead to normalization of conductive hearing loss. Revision middle fossa repair or previous stapes surgery may be associated with postoperative sensorineural hearing loss.

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