Skip to main content Accessibility help

Recent advances in superior semicircular canal dehiscence syndrome

  • G Chilvers (a1) and I McKay-Davies (a1)



This study aimed to review the current advances in superior semicircular canal dehiscence syndrome and to ascertain its aetiology, whether dehiscence size correlates with symptoms, signs and investigation results, the best investigations, and its surgical management.


A literature search using the key words ‘superior semicircular canal dehiscence’ was performed using the Allied and Complementary Medicine Database and the Embase, Health Management Information Consortium, Medline, PsycINFO, British Nursing Index, Cinahl and Health Business Elite databases for the period January 2009 to May 2014. Systematic reviews, meta-analyses, randomised controlled trials, prospective and retrospective case series, case reports, and observational studies were included.


Of the 205 papers identified, 35 were considered relevant.


The aetiology of superior semicircular canal dehiscence syndrome is unclear. Dehiscence size significantly affects the air–bone gap and ocular vestibular evoked myogenic potential thresholds. Computed tomography evaluation has a high false positive rate. The middle cranial fossa approach is the surgical standard for treating this syndrome; however, the transmastoid approach is gaining popularity.


Corresponding author

Address for correspondence: Mr G ChilversENT Department, St Michaels Hospital, University Hospitals Bristol, Southwell Street, Bristol, BS2 8EG, UK, E-mail:


Hide All
1Minor, 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;124:249–58
2Sohmer, H, Freeman, S, Perez, R. Semicircular canal fenestration – improvement of bone- but not air-conducted auditory thresholds. Hear Res 2000;187:105–10
3Stenfelt, S, Goode, RL. Bone-conducted sound: physiological and clinical aspects. Otol Neurotol 2005;26:1245–61
4Hiroven, TP, Carey, JP, Liang, CJ, Minor, LB. Superior canal dehiscence: mechanisms of pressure sensitivity in a chinchilla model. Arch Otolaryngol Head Neck Surg 2001;127:1331–6
5Carey, JP, Minor, LB, Nager, GT. Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg 2000;126:137–47
6Takahashi, N, Tsunoda, A, Shirakura, S, Kitamura, K. Anatomical feature of the middle cranial fossa in fetal periods: possible etiology of superior canal dehiscence syndrome. Acta Otolaryngol 2012;132:385–90
7Gracia-Tello, B, Cisneros, A, Crovetto, R, Martinez, C, Rodriguez, O, Lecumberri, I et al. Effect of semi-circular canal dehiscence on contralateral canal bone thickness. Acta Otorrinolaringol Esp 2013;64:97101
8Suryanarayanan, R, Lesser, TH. ‘Honeycomb’ tegmen: multiple tegmen defects associated with superior semicircular canal dehiscence. J Laryngol Otol 2010;124:560–3
9Nadaraja, GS, Gurgel, RK, Fischbein, NJ, Anglemyer, A, Monfared, A, Jackler, RK et al. Radiographic evaluation of the tegmen in patients with superior semicircular canal dehiscence. Otol Neurotol 2012;33:1245–50
10El Hadi, T, Sorrentino, T, Calmels, MN, Fraysse, B, Deguine, O, Marx, M. Spontaneous tegmen defect and semicircular canal dehiscence: same etiopathogenic entity? Otol Neurotol 2012;33:591–5
11Nadgir, RN, Ozonoff, A, Devaiah, AK, Halderman, AA, Sakai, O. Superior semicircular canal dehiscence: Congenital or acquired condition? AJNR Am J Neuroradiol 2011;32:947–9
12Parlea, E, Georgescu, M, Calarasu, R. Superior canal dehiscence syndrome – case report. Romanian Journal of Neurology 2012;11:142–6
13Minor, LB. Superior canal dehiscence syndrome. Am J Otol 2000;21:919
14Whyte Orozco, J, Martinez, C, Cisneros, A, Obon, J, Gracia-Tello, B, Angel Crovetto, M. Defect of the bony roof in the superior semicircular canal and its clinical implications. Acta Otorrinolaringol Esp 2011;62:199204
15Crovetto-De la Torre, MA, Whyte-Orozco, J, Crovetto-Martinez, R, Whyte-Orozco, A, Obon-Nogues, JA, Martinez-Rodriguez, A. A new cause of structural vertigo: superior semicircular canal dehiscence. Rev Neurol 2011;52:751–8
16Yu, A, Teich, DL, Moonis, G, Wong, ET. Superior semicircular canal dehiscence in East Asian women with osteoporosis. BMC Ear Nose Throat Disord 2012;12:8
17Chien, WW, Janky, K, Minor, LB, Carey, JP. Superior canal dehiscence size: multivariate assessment of clinical impact. Otol Neurotol 2012;33:810–15
18Yuen, HW, Boeddinghaus, R, Eikelboom, RH, Atlas, MD. The relationship between the air-bone gap and the size of superior semicircular canal dehiscence. Ann Acad Med Singapore 2011;40:5964
19Niesten, ME, Hamberg, LM, Silverman, JB, Lou, KV, McCall, AA, Windsor, A et al. Superior canal dehiscence length and location influences clinical presentation and audiometric and cervical vestibular-evoked myogenic potential testing. Audiol Neurootol 2014;19:97105
20Manzari, L, Burgess, AM, McGarvie, LA, Curthoys, IS. Ocular and cervical vestibular evoked myogenic potentials to 500 Hz fz bone-conducted vibration in superior semicircular canal dehiscence. Ear Hear 2012;33:508–20
21Pfammatter, A, Darrouzet, V, Gartner, M, Somers, T, Van Dinther, J, Trabalzini, F et al. A superior semicircular canal dehiscence syndrome multicenter study: is there an association between size and symptoms? Otol Neurotol 2010;31:447–54
22Chi, FL, Ren, DD, Dai, CF. Variety of audiologic manifestations in patients with superior semicircular canal dehiscence. Otol Neurotol 2010;31:210
23Mondina, M, Bonnard, D, Barreau, X, Darrouzet, V, Franco-Vidal, V. Anatomo-radiological study of the superior semicircular canal dehiscence of 37 cadaver temporal bones. Surg Radiol Anat 2013;35:55–9
24Tavassolie, TS, Penninger, RT, Zuniga, MG, Minor, LB, Carey, JP. Multislice computed tomography in the diagnosis of superior canal dehiscence: how much error, and how to minimize it? Otol Neurotol 2012;33:215–22
25Crovetto, M, Whyte, J, Rodriguez, OM, Lecumberri, I, Martinez, C, Elexpuru, J. Anatomo-radiological study of the Superior Semicircular Canal Dehiscence: Radiological considerations of Superior and Posterior Semicircular Canals. Eur J Radiol 2010;76:167–72
26Masaki, Y. The prevalence of superior canal dehiscence syndrome as assessed by temporal bone computed tomography imaging. Acta Otolaryngol 2011;131:258–62
27Eibenberger, K, Carey, J, Ehtiati, T, Trevino, C, Dolberg, J, Haslwanter, T. A novel method of 3D image analysis of high-resolution cone beam CT and multi slice CT for the detection of semicircular canal dehiscence. Otol Neurotol 2014;35:329–37
28Browaeys, P, Larson, T, Wong, M, Patel, U. Can MRI replace CT in evaluating semicircular canal dehiscence? AJNR Am J Neuroradiol 2013;34:1421–7
29Brantberg, K, Lofquist, L, Fransson, PA. Large vestibular evoked myogenic potentials in response to bone-conducted sounds in patients with superior canal dehiscence syndrome. Audiol Neurootol 2004;9:173–82
30Milojcic, R, Guinan, JJ Jr., Rauch, SD, Herrmann, BS. Vestibular evoked myogenic potentials in patients with superior semicircular canal dehiscence. Otol Neurotol 2013;34:360–7
31Zuniga, MG, Janky, KL, Nguyen, KD, Welgampola, MS, Carey, JP. Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol 2013;34:121–6
32Kantner, C, Gurkov, R. Characteristics and clinical applications of ocular vestibular evoked myogenic potentials. Hear Res 2012;294:5563
33Vlastarakos, PV, Proikas, K, Tavoulari, E, Kikidis, D, Maragoudakis, P, Nikolopoulos, TP. Efficacy assessment and complications of surgical management for superior semicircular canal dehiscence: a meta-analysis of published interventional studies. Eur Arch Otorhinolaryngol 2009;266:177–86
34Ward, BK, Agrawal, Y, Nguyen, E, Della Santina, CC, Limb, CJ, Francis, HW et al. Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. Otol Neurotol 2012;33:1386–91
35Beyea, JA, Agrawal, SK, Parnes, LS. Transmastoid semicircular canal occlusion: a safe and highly effective treatment for benign paroxysmal positional vertigo and superior canal dehiscence. Laryngoscope 2012;122:1862–6
36Amoodi, HA, Makki, FM, McNeil, M, Bance, M. Transmastoid resurfacing of superior semicircular canal dehiscence. Laryngoscope 2011;121:1117–23
37Fiorino, F, Barbieri, F, Pizzini, FB, Beltramello, A. A dehiscent superior semicircular canal may be plugged and resurfaced via the transmastoid route. Otol Neurotol 2010;31:136–9
38Achar, P, Nichani, J, Freeman, S, Lloyd, S. Management of superior semicircular canal dehiscence-the perspective of neurotologists. Clin Otolaryngol 2012;37:152
39Silverstein, H, Van Ess, MJ. Complete round window niche occlusion for superior semicircular canal dehiscence syndrome: a minimally invasive approach. Ear Nose Throat J 2009;88:1042–56
40Nikkar-Esfahani, A, Banerjee, A. Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence. J Laryngol Otol 2013;127:705–7
41Silverstein, H, Kartush, JM, Parnes, LS, Poe, DS, Babu, SC, Levenson, MJ et al. Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series. Am J Otolaryngol 2014;35:286–93



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed