The article presents a minimally invasive surgical treatment for this condition performed as a same-day surgery which has had a high degree of success. Previous surgical treatments for this condition require opening of the skull and a combined ear and brain surgery approach for repair.
Dr. Levenson reports that new patients treated since the completion of the study have also enjoyed a high degree of success with round window reinforcement for superior semicircular canal dehiscence.
Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series.
Authors: Silverstein H1, Kartush JM2, Parnes LS3, Poe DS4, Babu SC2, Levenson MJ5, Wazen J6, Ridley RW6.
Abstract
PURPOSE:
To evaluate the outcome of round window (RW) tissue reinforcement in the management of superior semicircular canal dehiscence (SSCD).
MATERIALS AND METHODS:
Twenty-two patients with confirmed diagnosis of SSCD by clinical presentation, imaging, and/or testing were included in the study. Six surgeons at four institutions conducted a multicenter chart review of patients treated for symptomatic superior canal dehiscence using RW tissue reinforcement or complete RW occlusion. A transcanal approach was used to reinforce the RW with various types of tissue. Patients completed a novel postoperative survey, grading preoperative and postoperative symptom severity.
RESULTS:
Analysis revealed statistically significant improvement in all symptoms with the exception of hearing loss in 19 patients who underwent RW reinforcement. In contrast, 2 of 3 participants who underwent the alternate treatment of RW niche occlusion experienced worsened symptoms requiring revision surgery.
CONCLUSION:
RW tissue reinforcement may reduce the symptoms associated with SSCD. The reinforcement technique may benefit SSCD patients by reducing the “third window” effect created by a dehiscent semicircular canal. Given its low risks compared to middle cranial fossa or transmastoid canal occlusion, RW reinforcement may prove to be a suitable initial procedure for intractable SSCD. In contrast, complete RW occlusion is not advised.