Longitudinal Cognitive and Neurobehavioral Functional Outcomes Before and After Repairing Otic Capsule Dehiscence

Area of Science:

• Neuroscience
• Otolaryngology
• Cognitive Psychology

Background:

• Peripheral vestibular dysfunction, particularly from gravitational receptor asymmetries, is linked to cognitive deficits.
• Superior semicircular canal dehiscence syndrome (SSCDS) is a condition where these asymmetries may cause neurobehavioral sequelae.

Purpose of the Study:

• To quantitatively assess cognitive and neurobehavioral changes in patients with SSCDS following surgical repair.
• To compare outcomes across different surgical approaches for SSCDS, including superior canal dehiscence (SCD) repair and round window reinforcement (RWR) for otic capsule defects (no-iOCD).

Main Methods:

• Prospective study of 17 patients (13 adult, 4 pediatric) with SSCDS undergoing different surgical interventions.
• Neuropsychological testing battery administered preoperatively and at 3-month intervals postoperatively for 12 months.
• Included tests for depression (BDI), intelligence (WRIT), memory and learning (WRAML), executive function (D-KEFS), and disease-specific impact (DHI, HIT-6).

Main Results:

• Significant improvements were observed in visual and verbal memory (WRAML) for patients with no-iOCD and combined SCD/no-iOCD repairs, but not SCD repair alone.
• The no-iOCD group showed improved attention (WRAML) postoperatively, matching other groups.
• All groups demonstrated reduced depression (BDI), dizziness (DHI), and headache impact (HIT-6), with stable IQ scores.

Conclusions:

• Surgical intervention for SSCDS leads to marked improvements in cognitive and neurobehavioral function.
• Variability in outcomes may relate to disease duration, and initial performance delays might indicate brain reorganization.
• Further research with larger cohorts and longer follow-up is needed to fully understand cognitive recovery optimization.