J Neurol Surg B Skull Base 2014; 75 - A128
DOI: 10.1055/s-0034-1370534

Surgical Treatment of Superior Semicircular Canal Dehiscence Is Associated with Significant Improvement in Clinical Outcome

Lawrance Chung 1, Nolan Ung 1, Kimberly Thill 1, Quinton Gopen 1, Isaac Yang 1
  • 1Los Angeles, USA

Introduction: Superior semicircular canal dehiscence (SSCD) is characterized by a fistula between the superior semicircular canal with the skull base of the temporal fossa. Hearing loss, pulsatile tinnitus, chronic disequilibrium, and autophony are commonly elicited as aberrant communication occurs between the inner ear and its surrounding structures. Optimal treatment modality for this disease is not yet fully elucidated. In this study, we analyze the largest reported series of SSCD surgically treated patients.

Methods: Patients were retrospectively reviewed and evaluated for surgical treatment of SSCD at UCLA from 2011–2013. All patients were treated by the same surgical team with a middle fossa craniotomy to resurface the skull base temporal floor for SSCD repair. Symptomatic improvements associated with different clinical factors and demographics were analyzed with a Chi-squared test. P values of less than 0.05 were considered statistically significant.

Results: A total of 8 patients, 3 male (37.5%) and 5 female (62.5%) with a mean age of 54.4 years, presented with SSCD. 3 cases were located on the left while 5 were located on the right. All 8 patients were treated with a middle fossa craniotomy for temporal floor skull base repair and had an average follow up of 18 months ± 3 months. 87.5% of treated patients reported dramatic improvements of their clinical symptoms whereas 12.5% reported slight improvement in clinical symptoms after surgical intervention (p = .03). Of the patients with significantly improved symptoms, none have reported a recurrence of their symptoms.

Conclusion: Our data suggests that middle fossa craniotomy is associated with significant symptom improvement in patients with SSCD. Age and gender were not predictive of improved patient outcome. Older patients treated with surgery were similarly associated with symptom improvement as younger patients. Future studies with longer term follow up can further elucidate the permanent efficacy of this treatment for SSCD.