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Head rotation evoked tinnitus due to superior semicircular canal dehiscence

  • E-C Nam (a1) (a2), R Lewis (a3), H H Nakajima (a2) (a3), S N Merchant (a2) (a3) and R A Levine (a2) (a3) (a4)...
Abstract
AbstractIntroduction:

Superior semicircular canal dehiscence affects the auditory and vestibular systems due to a partial defect in the canal's bony wall. In most cases, sound- and pressure-induced vertigo are present, and are sometimes accompanied by pulse-synchronous tinnitus.

Case presentation:

We describe a 50-year-old man with superior semicircular canal dehiscence whose only complaints were head rotation induced tinnitus and autophony. Head rotation in the plane of the right semicircular canal with an angular velocity exceeding 600°/second repeatedly induced a ‘cricket’ sound in the patient's right ear. High resolution temporal bone computed tomography changes, and an elevated umbo velocity, supported the diagnosis of superior semicircular canal dehiscence.

Conclusion:

In addition to pulse-synchronous or continuous tinnitus, head rotation induced tinnitus can be the only presenting symptom of superior semicircular canal dehiscence without vestibular complaints. We suggest that, in our patient, the bony defect of the superior semicircular canal (‘third window’) might have enhanced the flow of inner ear fluid, possibly producing tinnitus.

Copyright
Corresponding author
Address for correspondence: Dr Robert A Levine, Eaton-Peabody Laboratory, Massachusetts Eye & Ear Infirmary, 243 Charles Street, Boston, MA 02114-3096, USA. Fax: +1 2617 720 4408 E-mail: Robert_Levine@MEEI.harvard.edu
References
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1Cullington H. Tinnitus evoked by finger movement: brain plasticity after peripheral deafferentation. Neurology 2001;56:978–79
2Levine RA. Somatic tinnitus. In Hamilton SJ, ed. Tinnitus: Theory and Management. Ontario: BC Decker, 2004;8124
3Rosowski JJ, Nakajima HH, Merchant SN. Clinical utility of laser-Doppler vibrometer measurements in live normal and pathologic human ears. Ear Hear 2008;29:319
4Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005;115:1717–27
5Brantberg K, Bergenius J, Mendel L. Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 2001;121:6875
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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