An evidenced-based diagnostic tool for superior semicircular canal dehiscence syndrome

Christian G Fritz; Garrett G Casale; Lulia A Kana; Robert S Hong

doi:10.1016/j.joto.2023.09.006

An evidenced-based diagnostic tool for superior semicircular canal dehiscence syndrome

J Otol. 2023 Oct;18(4):230-234. doi: 10.1016/j.joto.2023.09.006. Epub 2023 Sep 20.

Authors

Christian G Fritz^{1

2}, Garrett G Casale¹, Lulia A Kana^{1

3}, Robert S Hong^{1

3}

Affiliations

¹ Michigan Ear Institute, Farmington Hills, Michigan, USA.
² Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.
³ Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, MI, USA.

Abstract

Purpose: To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence (SSCD) on high-resolution CT.

Materials and methods: Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center.

Results: A total of 168 patients were included, of which 118 had imaging-confirmed SSCD. On univariate analysis significant predictors of SSCD presence were: sound/pressure-induced vertigo (p = 0.006), disequilibrium (p = 0.008), hyperacusis (p = 0.008), and autophony (p = 0.034). Multivariate analysis enabled a 14-point symptom-weighted tool to be developed, wherein a score of ≥6 raised the suspicion of SSCD (≥70% likelihood of being present), R² = 0.853.

Conclusions: The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation. Using the evidenced-based diagnostic tool validated herein, a score ≥6 with any symptom combination justifies ordering a CT scan.

Keywords: Clinical predictors; Diagnostic tool; SSCD; Superior semicircular canal dehiscence; Third window.