Accuracy of Computed Tomography Detection of Superior Canal Dehiscence

Sequeira, Sunitha M.; Whiting, Bruce R.; Shimony, Joshua S.; Vo, Katie D.; Hullar, Timothy E.

doi:10.1097/mao.0b013e318238280c

Cited by 78 publications

(32 citation statements)

References 19 publications

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“…This study, as previous studies in the literature, 9,[12][13][14][15]19 is limited by the lack of surgical confirmation of the CT diagnosis but, clearly, patients with negative radiologic findings are not likely to be considered for surgical exploration and, similarly, not all patients with a radiologic diagnosis and clinical evidence of SSC dehiscence choose to undergo surgery.…”

mentioning

confidence: 60%

“…9,[12][13][14] However, significant differences have been found between autopsy-proven versus CT-detected SSC dehiscence. [15][16][17] It has been proposed that reformatted CT images oriented parallel (plane of Po¨schl) and orthogonal (plane of Stenver) to the plane of the SSC may improve the sensitivity and specificity in detecting SSC dehiscence.…”

Section: Introductionmentioning

confidence: 80%

“…[6][7][8] Computed tomography (CT) imaging has an important role in the demonstration of the dehiscence of the SSC confirming the diagnosis of SSC dehiscence syndrome. 9,10 However, temporal bone CT accuracy depends on the availability of multidetector row CT capable of thin-section collimation with isotropic voxel allowing multiplanar reformation of the images.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence

Sparacia

Iaia

2017

Neuroradiol J

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Purpose The purpose of this article is to assess the diagnostic performance of computed tomography (CT) reformatted images for detection of superior semicircular canal (SSC) dehiscence. Material and methods Forty-two patients, with sound- and/or pressure-induced vestibular symptoms, and 42 control participants underwent helical CT examination with a highly collimated beam (0.5 mm). Reformatted images of the vestibular labyrinth were obtained in the standard axial and coronal planes (group A images), and in a plane parallel and perpendicular to the SSC (group B images). Diagnostic performance obtained by evaluating the group A images alone and the group B images alone was analyzed by using the area under the receiver operating characteristic curve (AUC). Results The diagnostic performance of group A images was AUC = 0.929 with an overall accuracy of 92.9%. The diagnostic performance of group B images was AUC = 0.988 with an overall accuracy of 98.8%. The evaluation of group B images alone showed an improved diagnostic performance over the group A images alone. Conclusion Thin-section 0.5-mm collimation CT with reformatted images oriented in the plane parallel and perpendicular to the SSC improves diagnostic accuracy in assessing for SSC dehiscence in comparison to CT images with reconstructions limited to traditional axial and coronal planes

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mentioning

confidence: 60%

Section: Introductionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence

Sparacia

Iaia

2017

Neuroradiol J

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“…We developed a method of assessing SCD length taking the curvature of the superior canal into account by making an oblique reconstruction of the SSC. However, recent studies have described the risk of overestimation of the SCD length by using CT scans [Sequeira et al, 2011; Tavassolie et al, 2012]. Risk of overestimation and false-positive diagnoses of SCD have especially been described for patients with a small dehiscence (<3 mm) [Sequeira et al, 2011].…”

Section: Discussionmentioning

confidence: 99%

Superior Canal Dehiscence Length and Location Influences Clinical Presentation and Audiometric and Cervical Vestibular-Evoked Myogenic Potential Testing

Niesten¹,

Hamberg²,

Silverman

et al. 2014

Audiol Neurotol

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Superior canal dehiscence (SCD) is caused by an absence of bony covering of the arcuate eminence or posteromedial aspect of the superior semicircular canal. However, the clinical presentation of SCD syndrome varies considerably, as some SCD patients are asymptomatic and others have auditory and/or vestibular complaints. In order to determine the basis for these observations, we examined the association between SCD length and location with: (1) auditory and vestibular signs and symptoms; (2) air conduction (AC) loss and air-bone gap (ABG) measured by pure-tone audiometric testing, and (3) cervical vestibular-evoked myogenic potential (cVEMP) thresholds. 104 patients (147 ears) underwent SCD length and location measurements using a novel method of measuring bone density along 0.2-mm radial CT sections. We found that patients with auditory symptoms have a larger dehiscence (median length: 4.5 vs. 2.7 mm) with a beginning closer to the ampulla (median location: 4.8 vs. 6.4 mm from ampulla) than patients with no auditory symptoms (only vestibular symptoms). An increase in AC threshold was found as the SCD length increased at 250 Hz (95% CI: 1.7-4.7), 500 Hz (95% CI: 0.7-3.5) and 1,000 Hz (95% CI: 0.0-2.5), and an increase in ABG as the SCD length increased at 250 Hz (95% CI: 2.0-5.3), 500 Hz (95% CI: 1.6-4.6) and 1,000 Hz (95% CI: 1.3-3.3) was also seen. Finally, a larger dehiscence was associated with lowered cVEMP thresholds at 250 Hz (95% CI: -4.4 to -0.3), 500 Hz (95% CI: -4.1 to -1.0), 750 Hz (95% CI: -4.2 to -0.7) and 1,000 Hz (95% CI: -3.6 to -0.5) and a starting location closer to the ampulla at 250 Hz (95% CI: 1.3-5.1), 750 Hz (95% CI: 0.2-3.3) and 1,000 Hz (95% CI: 0.6-3.5). These findings may help to explain the variation of signs and symptoms seen in patients with SCD syndrome.

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“…Multiplanar reconstructions and reformats parallel to (Pöschl plane) and perpendicular to (Stenvers plane) the superior semicircular canal are used to demonstrate the dehiscence to best advantage (Fig 2). 3,8,9 At audiometry, a characteristic air-bone gap results from increased bone and decreased air conduction. This phenomenon occurs most significantly at lower sound frequencies (below 1 kHz), a range at which acoustic energy is readily dissipated (Fig 3).…”

Section: Superior Semicircular Canal Dehiscencementioning

confidence: 99%

Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond

Moonis

Halpin

et al. 2016

AJNR Am J Neuroradiol

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SUMMARY:Third window abnormalities are defects in the integrity of the bony structure of the inner ear, classically producing sound-/ pressure-induced vertigo (Tullio and Hennebert signs) and/or a low-frequency air-bone gap by audiometry. Specific anatomic defects include semicircular canal dehiscence, perilabyrinthine fistula, enlarged vestibular aqueduct, dehiscence of the scala vestibuli side of the cochlea, X-linked stapes gusher, and bone dyscrasias. We discuss these various entities and provide key examples from our institutional teaching file with a discussion of symptomatology, temporal bone CT, audiometry, and vestibular-evoked myogenic potentials.ABBREVIATIONS: EVAS ϭ enlarged vestibular aqueduct syndrome; SSCCD ϭ superior semicircular canal dehiscence

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Accuracy of Computed Tomography Detection of Superior Canal Dehiscence

Cited by 78 publications

References 19 publications

Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence

Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence

Superior Canal Dehiscence Length and Location Influences Clinical Presentation and Audiometric and Cervical Vestibular-Evoked Myogenic Potential Testing

Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond

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