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Asymptomatic superior semicircular canal dehiscence
L Verrecchia1,2, K Edholm3, M Pekkari1,2
1ENT Unit, Department of Clinical Science, Intervention and Technology - CLINTEC, Karolinska Institutet, Solna.
The Journal of Laryngology and Otology
|October 27, 2021
Summary
Vestibular evoked myogenic potential testing can detect superior semicircular canal dehiscence without symptoms. This finding suggests reduced specificity for superior canal dehiscence syndrome when relying solely on this test.
Area of Science:
- Otolaryngology
- Neuroscience
- Audiology
Background:
- Superior semicircular canal dehiscence (SSCD) is a condition where bone erodes over the superior semicircular canal.
- Symptoms of SSCD often include vertigo, oscillopsia, and auditory symptoms.
- Vestibular evoked myogenic potential (VEMP) testing is commonly used to diagnose SSCD.
Observation:
- A 50-year-old male with Ménière's disease presented with an enhanced VEMP response in the left ear.
- Temporal bone CT scan confirmed unilateral left-sided superior semicircular canal dehiscence.
- The patient remained asymptomatic for SSCD.
Findings:
- The presence of superior semicircular canal dehiscence was confirmed via imaging.
- The enhanced VEMP response indicated dehiscence but not necessarily symptomatic SSCD.
- This case highlights potential overdiagnosis of SSCD based on VEMP results alone.
Implications:
- Enhanced VEMP response may indicate asymptomatic superior semicircular canal dehiscence.
- VEMP testing alone may have reduced specificity for diagnosing symptomatic SSCD.
- Further investigation is warranted when VEMP results are incongruent with clinical presentation.
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