A Superior Semicircular Canal Dehiscence Syndrome Multicenter Study

Pfammatter, Alain; Darrouzet, V.; Gärtner, Marcel; Somers, Thomas; Dinther, Joost van; Trabalzini, Franco; Denis, Arnaud; Linder, Thomas

doi:10.1097/mao.0b013e3181d27740

Cited by 79 publications

(60 citation statements)

References 24 publications

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“…Pfammatter et al [2010] divided 27 patients based on their symptoms and signs and evaluated the association between the symptoms/signs and the size of the SCD. They reported that the patient group with a larger-size SCD ( ≥ 2.5 mm) presented predominantly with cochleovestibular symptoms and/or signs, lower VEMP thresholds and objective vestibular findings.…”

Section: Discussionmentioning

confidence: 99%

Costimulation of the Horizontal Semicircular Canal during Skull Vibrations in Superior Canal Dehiscence Syndrome

Park¹,

Kim²,

Kim³

et al. 2014

Audiol Neurotol

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A sound- and pressure-induced vestibuloocular reflex (VOR) has been described as vertical and torsional in superior canal dehiscence (SCD), and the rotational axes of induced VOR have been assumed to fit with the axis of the affected superior semicircular canal (SC). However, it has been difficult to characterize the pattern of vibration-induced VOR (ViVOR). We aimed to characterize the pattern of ViVOR by comparing the intensity and the axis of ViVOR with several clinical parameters of SCD. Ten symptomatic SCD patients were recruited. SCD size and location were measured on a reformatted image in the plane of the SC. Unilateral vibratory stimulation (100 Hz) was applied to the mastoid surface. ViVOR were recorded using 3D videooculography. The median 3D velocity of ViVOR was measured and the 3D vector trajectory plotted for reference against the axes of the human semicircular canals. A correlation between the magnitude of ViVOR and the size of SCD was evaluated. We also compared the location of SCD with the vertical-to-torsional component ratio of the ViVOR. ViVOR were present in 7 patients; 6 patients showed a substantial horizontal component in the excitatory direction in addition to strong torsional and weak vertical components. The computed rotational axes of ViVOR were located mostly between the axes of the ipsilateral SC and horizontal canal (HC) with a variable deviation to the axis of the ipsilateral posterior canal (PC). The magnitude of ViVOR was not related to the size of the SCD. The vertical-to-torsional component ratio of ViVOR tended to decline as the dehiscence was closer to the common crus. In SCD, mastoid vibration may stimulate the affected-side HC and PC as well as the SC. SCD can be suspected when excitatory horizontal torsional ViVOR direct to the side of the auditory symptoms.

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Section: Discussionmentioning

confidence: 99%

Costimulation of the Horizontal Semicircular Canal during Skull Vibrations in Superior Canal Dehiscence Syndrome

Park¹,

Kim²,

Kim³

et al. 2014

Audiol Neurotol

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“…It has been recently demonstrated that dehiscence of Ն2.5 mm on CT is associated with significantly more vestibulocochlear symptoms than smaller dehiscences, 18 perhaps because a relatively high number of small dehiscences seen on CT are probably not correlated with a real anatomic dehiscence. 17 When SC dehiscence was seen, the measure of the dehiscence obtained with FIESTA was, on average, Ͼ50% higher than the CT value, congruent with the assumption that FIESTA is less sensitive than CT in depicting very thin bone coverage; because of this difference, the 2.5-mm threshold used with CT cannot be transposed to FIESTA.…”

Section: Discussionmentioning

confidence: 99%

Can MRI Replace CT in Evaluating Semicircular Canal Dehiscence?

Browaeys

Larson

Wong³

et al. 2013

AJNR Am J Neuroradiol

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“…La primera encontrada es la presencia de un defecto óseo completo (dehiscencia) localizado en el arco del canal semicircular superior, que hemos encontrado en un único caso. La dehiscencia del canal semicircular superior es un síndrome hoy día bien establecido como una forma de vestibulopatía periférica que puede cursar con alteraciones vestibulares y/o auditivas en unos casos, y en otros ser completamente asintomático (Hillman et al, 2006), habiendo indicios clínicos que relacionan la presencia de sintomatología vestibular y auditiva con el tamaño de la dehiscencia (Pfammatter et al, 2010).…”

Section: Discussionunclassified

Peculiaridades Anatómicas del Canal Semicircular Superior y su Posible Implicancia Clínica

et al. 2012

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RESUMEN:El objetivo fue estudiar las peculiaridades en la morfología apical del canal semicircular superior, a nivel de la eminencia arcuata con la finalidad de obtener conclusiones aplicativas. Se estudiaron 48 cabezas de cadáveres humanos (96 huesos temporales), con la intención de identificar la presencia de adelgazamiento o dehiscencia del canal semicircular superior, así como la existencia de surcos vasculares de la eminencia acuata que, discurriendo sobre el techo del canal, pudieran afectar a su integridad anatómica. El estudio incluye un análisis histológico (Tricrómico de Martins) y radiológico (Tomografía Computarizada) de los hallazgos positivos (dehiscencias y adelgazamientos), así como estudio tomográfico de los canales con surcos vasculares visibles. En un caso (1,04 %) hemos observado cómo el canal presentaba un defecto óseo completo (dehiscencia), en tres (3,12%) el canal presentaba una pared muy delgada cuyo grosor no excedía de 0,2 mm. En 12 casos (12,5%) la eminencia arcuata estaba recorrida por surcos por el que discurrían vasos colaterales meníngeos, que determinaron una concavidad entre 0,1 y 0,2 mm, mientras que el grosor medio de dicha pared en estos casos fue de 1,2 mm. De las tres peculiaridades estudiadas, la falta de cobertura ósea es la que produce el síndrome de dehiscencia del canal semicircular superior. Los canales que presentaban una cubierta adelgazada pueden estar predispuestos a una rotura y por lo tanto causar patología en el canal. En cambio la presencia de surcos vasculares que recorren la superficie apical del canal, no parece tener consecuencias al disminuir minimamente su grosor.PALABRAS CLAVE: Canal semicircular superior; Dehiscencia; Pared adelgazada; Surcos vasculares. INTRODUCCIÓNLos canales semicirculares superiores o anteriores se hallan situados en el espesor del peñasco del hueso temporal y forman parte del laberinto posterior del oído interno. Cada uno de ellos describe un arco que aproximadamente describe casi dos tercios de un círculo, y cuya longitud es de 15 a 20 mm, su orientación puede ser oblícuo hacia arriba y afuera o generalmente vertical, existiendo grandes diferencias individuales.Cada canal presenta dos extremos, uno dilatado (ampular), elíptico, con un diámetro de 3 mm y que desemboca en la porción superior y externa del vestíbulo; el otro extremo no ampular resultante de su unión con el del canal posterior, es circular con un diámetro de 1,5 mm y desemboca en la parte interna del vestíbulo.El canal semicircular superior levanta por su bucle la cortical de la superficie antero-superior del peñasco formando un relieve transversal, la eminencia arcuata. Sin embargo esta eminencia no coincide exactamente con el canal semicircular óseo superior siempre. Para Faure et al. (2003) está eminencia sólo corresponde al relieve del canal semicircular superior en el 37%.Un aspecto importante del canal es el espesor de la lámi-na ósea que separa el canal de la fosa cerebral media, que para Tsunoda (2001) Raramente esta cubierta está ausente, siendo entonces el...

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A Superior Semicircular Canal Dehiscence Syndrome Multicenter Study

Abstract: Patients with larger superior canal dehiscences show significantly more vestibulocochlear symptoms/signs, lower VEMP thresholds, and objective vestibular findings compared with smaller ones. Smaller dehiscences mainly present with either cochlear or vestibular dysfunction.

Cited by 79 publications

References 24 publications

Costimulation of the Horizontal Semicircular Canal during Skull Vibrations in Superior Canal Dehiscence Syndrome

Costimulation of the Horizontal Semicircular Canal during Skull Vibrations in Superior Canal Dehiscence Syndrome

Can MRI Replace CT in Evaluating Semicircular Canal Dehiscence?

Peculiaridades Anatómicas del Canal Semicircular Superior y su Posible Implicancia Clínica

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