Clinical factors associated with prolonged recovery after superior canal dehiscence surgery

Otol Neurotol. 2012 Jul;33(5):824-31. doi: 10.1097/MAO.0b013e3182544c9e.

Abstract

Objective: To identify clinical factors associated with prolonged recovery after superior canal dehiscence surgery.

Study design: Retrospective review.

Setting: Tertiary care academic medical center.

Patients: Thirty-three patients that underwent surgery for SCDS were identified from a database of 140 patients diagnosed with SCD (2000-2010) at the Massachusetts Eye and Ear Infirmary (U.S.A.). The diagnosis of SCDS was based on clinical signs and symptoms, audiometric and vestibular testing and high-resolution temporal bone computed tomography.

Intervention: For the primary repair, the superior canal was plugged in 31 patients through a middle fossa craniotomy approach and in 1 patient through a transmastoid approach. In 1 patient, the SCD was resurfaced through a middle fossa craniotomy approach.

Main outcome measures: Postoperative clinical signs and symptoms and factors that may influence duration of disequilibrium after surgery.

Results: Thirty-three patients (15-71 yr; mean, 43 yr) underwent surgery for SCDS on 35 ears (2 bilateral). Mean follow-up was 28.7 months (range, 3 mo to 10 yr); 33 of 33 (100%) patients experienced initial improvement of the chief complaint. Three patients required revision surgery, improving symptoms in 2 patients. Six patients had dizziness lasting more than 4 months postoperatively, and all had bilateral SCD, migraines, and a dehiscence of 3 mm or greater.

Conclusion: Surgical plugging of SCD is an effective management option to provide long-term improvement of the chief complaint in SCDS patients. Patients with bilateral SCD, a history of migraines, and larger defects may be at risk of prolonged recovery and should be appropriately counseled.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Audiometry
  • Dizziness / diagnostic imaging
  • Dizziness / surgery
  • Ear Diseases / diagnostic imaging
  • Ear Diseases / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Recovery of Function / physiology*
  • Retrospective Studies
  • Semicircular Canals / diagnostic imaging
  • Semicircular Canals / surgery*
  • Temporal Bone / diagnostic imaging
  • Temporal Bone / surgery*
  • Treatment Outcome
  • Vertigo / diagnostic imaging
  • Vertigo / surgery