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Pediatric Semicircular Canal Dehiscence: Radiographic and Histologic Prevalence, With Clinical Correlation
Duncan A Meiklejohn1, C Eduardo Corrales, Brian M Boldt
1*Stanford University Medical Center, Palo Alto, California; †Brigham and Women's Hospital, Boston, Massachusetts; ‡The Johns Hopkins University Hospital, Baltimore, Maryland; and §Lucile Salter Packard Children's Hospital, Palo Alto, California, U.S.A.
Insights
Semicircular canal dehiscence is common in infants, with thinner bone observed. This prevalence decreases with age as temporal bone thickness increases in children.
Area of Science:
- Otolaryngology
- Pediatric Radiology
- Anatomy
Background:
- Superior semicircular canal dehiscence (SSCD) and posterior semicircular canal dehiscence (PSCD) are abnormalities of the temporal bone.
- Understanding their prevalence and associated bone thickness in young children is crucial for diagnosis and management.
Purpose of the Study:
- To determine the prevalence of radiographic and histologic SSCD and PSCD in children aged 0 to 7 years.
- To assess changes in temporal bone thickness overlying the semicircular canals in this age group.
Main Methods:
- Retrospective review of 228 high-resolution computed tomography (HRCT) scans and 58 temporal bone specimens from children younger than 7 years.
- Analysis of radiographic and histopathologic findings, comparing prevalence and bone thickness across different age groups.
Main Results:
- Radiographic SSCD prevalence was 11.9% in infants <6 months, decreasing with age. Radiographic PSCD prevalence was 16.7% in infants <6 months, also decreasing with age.
- Temporal bone thickness overlying both the superior semicircular canal (SSC) and posterior semicircular canal (PSC) increased with age.
- No semicircular canal dehiscences were identified in the histologic specimens, despite radiographic findings.
Conclusions:
- Radiographic semicircular canal dehiscence is common in infants, particularly within the first 6 months of life.
- Histologic examination revealed thin bone, suggesting that radiographic findings in infants may represent developmental variations rather than true defects.
- The prevalence of radiographic dehiscence decreases with age, correlating with increasing temporal bone thickness.
Objectives:
To determine the prevalence of radiographic and histologic superior semicircular canal dehiscence (SSCD) and posterior semicircular canal dehiscence (PSCD) and associated changes in temporal bone thickness in children aged 0 to 7 years.
Study Design:
Retrospective chart review and histopathologic review of cadaveric bone specimens.
Setting:
Two tertiary referral centers.
Patients:
Children younger than 7 years who underwent high-resolution computed tomography scan including the temporal bones between 1998 and 2013 and temporal bones harvested from children younger than 7 years.
Intervention(S):
Two hundred twenty-eight computed tomography studies and 58 temporal bone specimens were reviewed. Available patient demographics were tabulated.
Main Outcome Measure(S):
Prevalence of SSCD and PSCD and bone thickness over semicircular canals, with comparison across age groups. Clinical data were extracted for patients with radiographic dehiscence.
Results:
Prevalence by ear of SSCD was 11.9%, 4.9%, 2.8%, and 0% and of PSCD was 16.7%, 2.4%, 1.4%, and 0% in children aged less than 6 months, 6 to 11 months, 12 to 35 months, and 3 to 7 years, respectively. SSCD was statistically more common before 1 year of age and PSCD before 6 months of age. Bone thickness overlying both the SSC and the PSC increased with age. Radiographic PSC bone was significantly thicker than SSC bone in patients older than 12 months. No dehiscences were found in the histologic specimens.
Conclusion:
Radiographic dehiscence of the canals is common in the first 6 months of life, with thin bone seen histologically. Prevalence decreases with increasing age as the bone overlying the canals increases in thickness.
