Recent ear surgery publication co-authored by Dr. Mark Levenson

Introduction by Dr. Mark Levenson

Patients who present with a history of dizziness or vertigo with loud noise or on compression of the ear canal may have a hole in the bony canal of the inner ear. These patients also frequently experience echophony (hearing your own voice reverberating) and a mild hearing loss in that ear. These symptoms may be related to the abnormality described in the abstract below.

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.