Evolution of Symptoms and CVEMPs after Middle Fossa Plugging of the Superior Semicircular Canal in the Superior Semicircular Canal Dehiscence Syndrome

Abstract

Aim: To report on symptoms and diagnostic workup in SSCD. Vestibular, audiological, and functional results after superior semicircular canal plugging through a middle fossa approach (MFA) are considered as well. Material: Patients showing a decreased threshold and increased amplitude in the VEMPs were included as SSCD cases. Overall 13 patients underwent surgery. One had been operated previously through a transmastoid approach. Only patients suffering from disabling vestibular symptoms were considered for surgery. The lumen of the superior canal was obscured with bone wax and bone dust through a MFA. Clinical symptoms, audiological, and vestibular data were analyzed and compared, pre- and postoperatively. Results: No neurosurgical complications were observed. Eight patients suffered from mixed hearing loss and Tullio phenomenon. A total of 12 patients had to stop their daily work, due to disability. Postoperatively, two patients had immediate severe vertigo and nystagmus associated with a sensorineural hearing loss. After 5 days, the audiological thresholds normalized. All patients improved from a clinical point of view and started working again. Two patients underwent vestibular rehabilitation during 4 months to assist and improve compensation. No patient had postoperative hearing deterioration. In seven of the eight preoperative hearing-impaired patients, we observed an air-bone gap closure and postoperative (sub)normal hearing. In 11 cases cVEMPs returned to normal.