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‘Soft reinforcement’ of the round window for superior semi-circular canal dehiscence syndrome

Published online by Cambridge University Press:  28 February 2020

A Gona*
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
J S Phillips
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
*
Author for correspondence: Mr Ajay Kumar Gona, Department of Otolaryngology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY, UK E-mail: ajaygona@gmail.com Fax: +44 1603 287288

Abstract

Background

Individuals with superior semi-circular canal syndrome often describe vestibular symptoms elicited by loud sounds, as well as other pressure-induced symptoms. They also often report other symptoms, including autophony, hyperacusis, cognitive dysfunction, spatial disorientation, anxiety and migraine headaches. Symptoms occur due to the presence of a ‘third window’ created by the dehiscence of the superior semi-circular canal. This case report describes a minimally invasive technique to provide soft reinforcement of the round window.

Case report

Our patient underwent a permeatal procedure whereby the tympanic membrane was raised to allow inspection of the middle ear. The round window niche was identified and the round window membrane was reinforced with fat. The mucosa of the bony meatus leading to the round window was then disrupted before the application of a double layer of perichondrium to allow further reinforcement.

Conclusion

The case provides support for the use of ‘soft reinforcement’ as a simple and effective technique to treat the symptoms of superior canal dehiscence syndrome.

Information

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited, 2020

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