Sound- and/or Pressure-Induced Vertigo Due to Bone Dehiscence of the Superior Semicircular Canal

Minor, Lloyd B.; Solomon, David; Zinreich, James; Zee, David S.

doi:10.1001/archotol.124.3.249

Cited by 978 publications

(879 citation statements)

References 30 publications

(27 reference statements)

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“…Typical symptoms for SCDS, first described by Minor et al (1), are hyperacusis for bone conducted sounds (often autophony) and vertigo, induced by loud sounds (Tullio phenomenon) or by increased pressure in the middle ear (Hennebert sign) or in the head (e.g. during sports).…”

Section: Introductionmentioning

confidence: 99%

Is Superior Canal Dehiscence Congenital or Acquired? A Case Report and Review of the Literature

Hegemann

Carey

2011

Otolaryngologic Clinics of North America

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This article presents a detailed case report of a patient who was diagnosed with superior canal dehiscence at 37 years of age, but who had a suspicious history for that syndrome from at least 10 years of age. The authors hypothesize several reasons for this late diagnosis, with the goal of helping pediatricians, otolaryngologists, and neurologists consider this syndrome in their differential diagnosis of children, adolescents, or adults experiencing dizziness. AbstractSuperior canal dehiscence syndrome (SCDS) is typically diagnosed in adulthood and not in children or adolescents, but it is believed that it is caused by a developmental or congenital anomaly. This theory would predict more diagnoses earlier in live, but until now the facts do not show that. We report a patient, in whom the diagnosis was made at age 37 but who had a suspicious history for that syndrome from at least age 10. We hypothesize some reasons for this late diagnosis and hope this case may have the effect, to make even pediatricians, ENT-doctors and neurologists seeing children think at this syndrome and to help some of their patients, to have a better live.

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Section: Introductionmentioning

confidence: 99%

Is Superior Canal Dehiscence Congenital or Acquired? A Case Report and Review of the Literature

Hegemann

Carey

2011

Otolaryngologic Clinics of North America

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“…Superior semicircular canal dehiscence (SCD) syndrome, first described by Minor et al (1998), is associated with sound and/or static pressure-induced vertigo. In addition to vestibular symptoms (Minor et al, 1998;Cremer et al, 2000;Minor, 2000;Brantberg et al, 2000), patients with the syndrome frequently have a super-sensitivity to bone-conducted auditory stimuli, and a decreased sensitivity to air-conducted sound (Minor et al, 2003;Mikulec et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…In addition to vestibular symptoms (Minor et al, 1998;Cremer et al, 2000;Minor, 2000;Brantberg et al, 2000), patients with the syndrome frequently have a super-sensitivity to bone-conducted auditory stimuli, and a decreased sensitivity to air-conducted sound (Minor et al, 2003;Mikulec et al, 2004). The increased air-conduction thresholds (20-60 dB) and the decreased bone-conduction thresholds (5-10 dB) together lead to a conductive hearing loss (e.g., air-bone gap) that is largest in the low frequencies (Mikulec et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…The air-bone gap (calculated as the difference between the bone-conducted and air-conducted thresholds) observed clinically in patients with SCD syndrome has been qualitatively explained by the 'third-window hypothesis' (Minor et al, 1998;Rosowski et al, 2004) that proposes that some of the volume velocity produced by the stapes in response to air-conducted (AC) stimuli is shunted away from the cochlea, through the dehiscent canal. This shunt causes a reduction in the flow of AC sound energy into the cochlea, indicated by increases in AC hearing thresholds.…”

Section: Introductionmentioning

confidence: 99%

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The effect of superior canal dehiscence on cochlear potential in response to air-conducted stimuli in chinchilla

Songer

Rosowski

2005

Hearing Research

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A superior semicircular canal dehiscence (SCD) is a break or hole in the bony wall of the superior semicircular canal. Patients with SCD syndrome present with a variety of symptoms: some with vestibular symptoms, others with auditory symptoms (including low-frequency conductive hearing loss) and yet others with both. We are interested in whether or not mechanically altering the superior canal by introducing a dehiscence is sufficient to cause the low-frequency conductive hearing loss associated with SCD syndrome. We evaluated the effect of a surgically introduced dehiscence on auditory responses to air-conducted (AC) stimuli in 11 chinchilla ears. Cochlear potential (CP) was recorded at the round-window before and after a dehiscence was introduced. In each ear, a decrease in CP in response to low frequency (<2 kHz) sound stimuli was observed after the introduction of the dehiscence. The dehiscence was then patched with cyanoacrylate glue leading to a reversal of the dehiscence-induced changes in CP. The reversible decrease in auditory sensitivity observed in chinchilla is consistent with the elevated AC thresholds observed in patients with SCD. According to the 'third-window' hypothesis the SCD shunts sound-induced stapes velocity away from the cochlea, resulting in decreased auditory sensitivity to AC sounds. The data collected in this study are consistent with predictions of this hypothesis.

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“…1). Minor et al (1998) found that they typically suffer from sound-induced vertigo, also known as Tullio phenomenon (TP). Sound stimuli within a subrange of the audible spectrum, typically between 500 Hz and 2 kHz at sound intensities of 100-110 dB (Minor 2000), trigger vestibular reactions in the plane of the dehiscent semicircular canal.…”

Section: Introductionmentioning

confidence: 99%

Identifying Mechanisms Behind the Tullio Phenomenon: a Computational Study Based on First Principles

Grieser

Kleiser

Obrist

2016

JARO

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Patients with superior canal dehiscence (SCD) suffer from events of dizziness and vertigo in response to sound, also known as Tullio phenomenon (TP). The present work seeks to explain the fluid-dynamical mechanisms behind TP. In accordance with the socalled third window theory, we developed a computational model for the vestibular signal pathway between stapes and SCD. It is based on first principles and accounts for fluid-structure interactions arising between endolymph, perilymph, and membranous labyrinth. The simulation results reveal a wave propagation phenomenon in the membranous canal, leading to two flow phenomena within the endolymph which are in close interaction. First, the periodic deformation of the membranous labyrinth causes oscillating endolymph flow which forces the cupula to oscillate in phase with the sound stimulus. Second, these primary oscillations of the endolymph induce a steady flow component by a phenomenon known as steady streaming. We find that this steady flow of the endolymph is typically in ampullofugal direction. This flow leads to a quasi-steady deflection of the cupula which increases until the driving forces of the steady streaming are balanced by the elastic reaction forces of the cupula, such that the cupula attains a constant deflection amplitude which lasts as long as the sound stimulus. Both response types have been observed in the literature. In a sensitivity study, we obtain an analytical fit which very well matches our simulation results in a relevant parameter range. Finally, we correlate the corresponding eye response (vestibuloocular reflex) with the fluid dynamics by a simplified model of lumped system constants. The results reveal a "sweet spot" for TP within the audible sound spectrum. We find that the underlying mechanisms which lead to TP originate primarily from Reynolds stresses in the fluid, which are weaker at lower sound frequencies.

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Sound- and/or Pressure-Induced Vertigo Due to Bone Dehiscence of the Superior Semicircular Canal

Cited by 978 publications

References 30 publications

Is Superior Canal Dehiscence Congenital or Acquired? A Case Report and Review of the Literature

Is Superior Canal Dehiscence Congenital or Acquired? A Case Report and Review of the Literature

The effect of superior canal dehiscence on cochlear potential in response to air-conducted stimuli in chinchilla

Identifying Mechanisms Behind the Tullio Phenomenon: a Computational Study Based on First Principles

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