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Simultaneous, unilateral plugging of superior and posterior semicircular canal dehiscences to treat debilitating hyperacusis

Published online by Cambridge University Press:  30 January 2014

P T Dang ,
T A Kennedy  and
S P Gubbels
P T Dang
Affiliation:
School of Medicine and Public Health, University of Wisconsin – Madison, USA
T A Kennedy
Affiliation:
Department of Radiology, Section of Neuroradiology, University of Wisconsin – Madison, USA
S P Gubbels*
Affiliation:
Department of Surgery, Division of Otolaryngology and Waisman Center, University of Wisconsin – Madison, USA
*
Address for correspondence: Dr Samuel P Gubbels, K4/719 CSC, 600 Highland Av, Madison, WI 53792-3284, USA Fax: +1 (608) 252 0926 E-mail: gubbels@surgery.wisc.edu
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Abstract

Objective:

To describe a case of bilateral superior and posterior semicircular canal dehiscences, and the use of a unilateral transmastoid approach to address both right-sided defects simultaneously.

Case report:

In a patient with right-sided hyperacusis, bilateral dehiscence of both the superior and the posterior semicircular canals was identified, located adjacent to the common crus, together with a right-sided, anterosuperiorly positioned sigmoid sinus and a high-riding jugular bulb. Results for audiography and cervical vestibular evoked myogenic potential testing were consistent with right-sided semicircular canal dehiscence. At surgery, a right-sided transmastoid approach provided access to plug both defects simultaneously, following posterior mobilisation of the sigmoid sinus. The patient's hyperacusis was completely resolved, with a 10–30 dB improvement in his right ear air conduction hearing, without decrement in bone conduction.

Conclusion:

In properly selected patients, a transmastoid approach can be used to effectively manage superior semicircular canal dehiscence and posterior semicircular canal dehiscence simultaneously. Pre-operative computed tomography is recommended to evaluate the dehiscence sites and to identify complicating vascular anatomy.

Keywords

MastoidSemicircular CanalsVestibular Evoked Myogenic PotentialsHearing Loss

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 2 , February 2014 , pp. 174 - 178
Copyright
Copyright © JLO (1984) Limited 2014 

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