Superior Semicircular Canal Dehiscence Revision Surgery Outcomes: A Single Institution's Experience

World Neurosurg. 2021 Dec:156:e408-e414. doi: 10.1016/j.wneu.2021.09.083. Epub 2021 Sep 25.

Abstract

Background: Superior semicircular canal dehiscence (SSCD) is an abnormality of the otic capsule, which normally overlies the superior semicircular canal. Surgical management is indicated in patients with persistent and debilitating symptoms. Given the complexity of the disease, there are patients who experience less favorable surgical outcomes and require revision surgery. The purpose of this study was to report to the rate of postoperative symptomatic improvement in patients who required revision surgery.

Methods: A retrospective analysis of patients undergoing SSCD surgical repair at a single institution was performed. Information on patient demographics, primary and secondary surgical approaches, surgical outcomes, and follow-up length was collected.

Results: Seventeen patients underwent 20 revision surgeries. There were eleven (65%) females and six (35%) males. Mean age of the cohorts was 50 years (range 30-68 years), and mean follow-up length was 6.8 months (range 0.1-31.1 months). Cerebrospinal fluid leak was noted in 67% of cases. The greatest postoperative symptomatic resolution was reported in oscillopsia (100%), headache (100%), and internal sound amplification (71%), while the least postoperative symptomatic resolution was reported in tinnitus (42%), aural fullness (40%), and dizziness (29%).

Conclusions: Revision surgery can provide symptomatic improvement in select SSCD patients; however, patients should be cautioned about the possibility of less favorable outcomes than in index surgery. Revision surgeries are associated with a considerably higher rate of perioperative cerebrospinal fluid leak.

Keywords: Middle cranial fossa; Superior semicircular canal dehiscence; Transmastoid.

MeSH terms

  • Adult
  • Aged
  • Cerebrospinal Fluid Leak / epidemiology
  • Dizziness / epidemiology
  • Female
  • Follow-Up Studies
  • Headache / epidemiology
  • Headache / etiology
  • Hearing Disorders / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Otologic Surgical Procedures / methods*
  • Postoperative Complications / epidemiology
  • Reoperation
  • Retrospective Studies
  • Semicircular Canal Dehiscence / surgery*
  • Semicircular Canals / surgery
  • Tinnitus / etiology
  • Treatment Outcome