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Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence
Gabrielle R Merchant1, Christof Röösli, Marlien E F Niesten
1*Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.; ‡Speech and Hearing Bioscience and Technology Program, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, U.S.A.; §Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; ∥Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland; ¶Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center, Utrecht, the Netherlands; and #Department of Otorhinolaryngology - Head and Neck Surgery, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
Hypothesis:
Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis.
Background:
The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions).
Methods:
Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations).
Results:
Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%.
Conclusion:
This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.
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