Semin Hear 2014; 35(02): 145-156
DOI: 10.1055/s-0034-1372530
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hyperacusis as a Symptom of Superior Semicircular Canal Dehiscence

Heather A. Monroe
1   Department of Otolaryngology, Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
,
Belinda C. Sinks
1   Department of Otolaryngology, Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
Further Information

Publication History

Publication Date:
29 April 2014 (online)

Abstract

This article provides a brief overview of how symptoms of hyperacusis and autophony can occur as a result of a dehiscence in the superior semicircular canal. Hyperacusis is a word typically used to describe hypersensitivity to external acoustic stimuli. In the case of superior semicircular canal dehiscence (SSCD), the patient is sensitive not only to loud sounds in their environment but also to the abnormally amplified internal sounds of their body. Superior semicircular canal dehiscence is diagnosed through a combination of case history, audiometric findings, vestibular evoked myogenic potential thresholds, and high-resolution computer-assisted tomography scans. Patients may initially present with auditory or vestibular symptoms or in some cases, both. The anatomy and physiology associated with SSCD will be briefly discussed along with symptoms and treatment options. The presentation of symptoms differs between individuals. Case studies will be utilized to bring all of these elements together.

 
  • References

  • 1 Minor LB, Solomon D, Zinreich JS, Zee DS. Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 1998; 124 (3) 249-258
  • 2 Chien WW, Carey JP, Minor LB. Canal dehiscence. Curr Opin Neurol 2011; 24 (1) 25-31
  • 3 Chen EY, Paladin A, Phillips G , et al. Semicircular canal dehiscence in the pediatric population. Int J Pediatr Otorhinolaryngol 2009; 73 (2) 321-327
  • 4 Minor LB. Superior canal dehiscence syndrome. Am J Otol 2000; 21 (1) 9-19
  • 5 Hirvonen TP, Weg N, Zinreich SJ, Minor LB. High-resolution CT findings suggest a developmental abnormality underlying superior canal dehiscence syndrome. Acta Otolaryngol 2003; 123 (4) 477-481
  • 6 Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005; 115 (10) 1717-1727
  • 7 Minor LB, Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N. Symptoms and signs in superior canal dehiscence syndrome. Ann N Y Acad Sci 2001; 942: 259-273
  • 8 Brandolini C, Modugno GC, Pirodda A. Dehiscence of the superior semicircular canal: a review of the literature on its possible pathogenic explanations. Eur Arch Otorhinolaryngol 2014; 271 (3) 435-437
  • 9 Yuen HW, Eikelboom RH, Atlas MD. Auditory manifestations of superior semicircular canal dehiscence. Otol Neurotol 2009; 30 (3) 280-285
  • 10 Schmuziger N, Allum J, Buitrago-Téllez C, Probst R. Incapacitating hypersensitivity to one's own body sounds due to a dehiscence of bone overlying the superior semicircular canal. A case report. Eur Arch Otorhinolaryngol 2006; 263 (1) 69-74
  • 11 Rosowski JJ, Songer JE, Nakajima HH, Brinsko KM, Merchant SN. Clinical, experimental, and theoretical investigations of the effect of superior semicircular canal dehiscence on hearing mechanisms. Otol Neurotol 2004; 25 (3) 323-332
  • 12 Chien WW, Janky K, Minor LB, Carey JP. Superior canal dehiscence size: multivariate assessment of clinical impact. Otol Neurotol 2012; 33 (5) 810-815
  • 13 Kim N, Steele CR, Puria S. Superior-semicircular-canal dehiscence: effects of location, shape, and size on sound conduction. Hear Res 2013; 301: 72-84
  • 14 Mikulec AA, McKenna MJ, Ramsey MJ , et al. Superior semicircular canal dehiscence presenting as conductive hearing loss without vertigo. Otol Neurotol 2004; 25 (2) 121-129
  • 15 Stenfelt S. Acoustic and physiologic aspects of bone conduction hearing. Adv Otorhinolaryngol 2011; 71: 10-21
  • 16 Freeman S, Sichel JY, Sohmer H. Bone conduction experiments in animals—evidence for a non-osseous mechanism. Hear Res 2000; 146 (1–2) 72-80
  • 17 Sohmer H, Freeman S, Geal-Dor M, Adelman C, Savion I. Bone conduction experiments in humans—a fluid pathway from bone to ear. Hear Res 2000; 146 (1–2) 81-88
  • 18 Cox KM, Lee DJ, Carey JP, Minor LB. Dehiscence of bone overlying the superior semicircular canal as a cause of an air-bone gap on audiometry: a case study. Am J Audiol 2003; 12 (1) 11-16
  • 19 Chien W, Ravicz ME, Rosowski JJ, Merchant SN. Measurements of human middle- and inner-ear mechanics with dehiscence of the superior semicircular canal. Otol Neurotol 2007; 28 (2) 250-257
  • 20 Minor LB, Carey JP, Cremer PD, Lustig LR, Streubel SO, Ruckenstein MJ. Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Otol Neurotol 2003; 24 (2) 270-278
  • 21 Watson SRD, Halmagyi GM, Colebatch JG. Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment. Neurology 2000; 54 (3) 722-728
  • 22 Bath AP, Harris N, McEwan J, Yardley MP. Effect of conductive hearing loss on the vestibulo-collic reflex. Clin Otolaryngol Allied Sci 1999; 24 (3) 181-183
  • 23 Streubel SO, Cremer PD, Carey JP, Weg N, Minor LB. Vestibular-evoked myogenic potentials in the diagnosis of superior canal dehiscence syndrome. Acta Otolaryngol Suppl 2001; 545 545 41-49
  • 24 Brantberg K, Löfqvist L, Fransson PA. Large vestibular evoked myogenic potentials in response to bone-conducted sounds in patients with superior canal dehiscence syndrome. Audiol Neurootol 2004; 9 (3) 173-182
  • 25 Welgampola MS, Colebatch JG. Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology 2005; 64 (10) 1682-1688
  • 26 Cloutier JF, Bélair M, Saliba I. Superior semicircular canal dehiscence: positive predictive value of high-resolution CT scanning. Eur Arch Otorhinolaryngol 2008; 265 (12) 1455-1460
  • 27 Alpini D, Pugnetti L, Caputo D, Cornelio F, Capobianco S, Cesarani A. Vestibular evoked myogenic potentials in multiple sclerosis: clinical and imaging correlations. Mult Scler 2004; 10 (3) 316-321