The association between semicircular canal dehiscence and Chiari type I malformation

Arch Otolaryngol Head Neck Surg. 2010 Oct;136(10):1009-14. doi: 10.1001/archoto.2010.169.

Abstract

Objective: To investigate the association between semicircular canal dehiscence (SCD) and Chiari type I malformation (CM-I).

Design: Retrospective case series.

Setting: Military tertiary referral center.

Patients: Adult patients with SCD.

Intervention: Review of records of patients diagnosed as having SCD for the radiologic diagnosis of CM-I and presenting symptoms.

Main outcome measures: The prevalence of CM-I among patients with SCD and the presenting symptoms of patients with SCD with and without a coexistent CM-I.

Results: Of 32 patients diagnosed as having SCD, 30 underwent magnetic resonance imaging of the brain. Seven patients (23%; 95% confidence interval [CI], 12%-41%) were found to have a CM-I. Chiari type I malformation was associated with superior SCD in 3 of 26 patients (12%; 95% CI, 3%-30%). Of 10 patients with bilateral superior SCD, 2 (20%; 95% CI, 5%-52%) had a CM-I. Five of 6 patients (83%; 95% CI, 42%-99%) had a CM-I with unilateral or bilateral posterior SCD. Twenty-nine records were reviewed for presenting symptoms, and no significant difference was observed between patients with SCD alone and those with an associated CM-I (P = .09-.64).

Conclusions: Among patients with SCD, the prevalence of CM-I is elevated. This association is especially marked in patients with posterior SCD. This finding suggests a relationship between CM-I and SCD, particularly with posterior SCD.

MeSH terms

  • Adult
  • Arnold-Chiari Malformation / pathology*
  • Audiometry
  • Bone Conduction / physiology
  • Evoked Potentials / physiology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Semicircular Canals / diagnostic imaging*
  • Semicircular Canals / physiopathology
  • Tomography, X-Ray Computed
  • Vestibular Diseases / diagnostic imaging*
  • Vestibular Diseases / physiopathology
  • Vestibular Function Tests