Transmastoid Occlusion Surgery for Superior Semicircular Canal Dehiscence Syndrome Improves Patient-Reported Quality-of-Life Measures and corrects cVEMP Thresholds and Amplitudes

Abstract

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Transmastoid Surgery for Superior Canal Dehiscence: Prospective Longitudinal Objective and Patient-Reported Audiovestibular Outcomes

“…Over time, from 3-month to 2-year follow-up, there was a statistically significant decline in THI score ( p = 0.01). The median HHI total score improved from 23 (IQR, 12-29) to 9 (1-19) at 1-year follow-up ( p = 0.04; CI, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. There was no statistically significant change in HHI score over time from the 3-month to 2-year follow-up ( p = 0.73).…”

“…Note that the median change was within what Jacobson and Newman (20) considered test-retest variability (significant change ≥18 points). In the cohorts of Crane et al (7), Jung et al (6), and de Wolf et al (9), postoperative mean DHI scores were 18 (standard deviation, ±15; range, 0-54), 32 (range, 0-98), and 27 (CI, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Although both preoperative and postoperative DHI scores in our cohort are lower, two aspects are in line with previous literature: 1) Crane et al did not find significant improvement in DHI scores for patients with preoperative DHI <30, and 2) postoperative, symptoms of dizziness are more prevalent than autophony (6,7,9,10).…”

“…In the cohorts of Crane et al (7), Jung et al (6), and de Wolf et al (9), postoperative mean DHI scores were 18 (standard deviation, ±15; range, 0-54), 32 (range, 0-98), and 27 (CI, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Although both preoperative and postoperative DHI scores in our cohort are lower, two aspects are in line with previous literature: 1) Crane et al did not find significant improvement in DHI scores for patients with preoperative DHI <30, and 2) postoperative, symptoms of dizziness are more prevalent than autophony (6,7,9,10). The DHI is not specific to the third-window produced sound-and pressure-induced dizziness but will also reflect postoperative vestibular dysfunction, explaining persistent dizziness symptoms despite successful repair.…”

“…Because the condition is not fatal, it is of particular importance that symptom improvement outweighs the risks of surgery. Most studies report postoperative symptom control based on medical records (1)(2)(3)(4)(5), but recent studies use self-assessment questionnaires and semistructured interviews to quantify and elaborate on the perceived disability after SCD repair (6)(7)(8)(9)(10). These studies suggest that disability from dizziness is more common postoperative than disability from autophony and hearing.…”

Development of semicircular canal occlusion

“…In 1998, Minor et al (1998) first reported eight cases of SCDS, and since then, many cases of SCDS have been reported (Steenerson et al, 2020;de Wolf et al, 2021;Kontorinis and Gaggini, 2021;Nieto et al, 2021;Ellsperman et al, 2022). The incidence of SCDS is low and its pathogenesis is unknown, and it may be related to head trauma, infection, and pathological changes in the middle ear or adjacent structures (Rosowski et al, 2004;Ward et al, 2017;Mau et al, 2018).…”