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Persistent Positional Vertigo in a Patient with Partial "Auto-Plugged" Superior Semicircular Canal Dehiscence: A Case
Eugen Constant Ionescu1, Samar Idriss2, Pierre Reynard3
1Department of Audiology and Neurotology, Lyon University Hospital, Lyon, France; Paris Hearing Institute, Research Center of Institut Pasteur, Inserm U1120, Paris, France.
The Journal of International Advanced Otology
|April 14, 2022
Summary
Persistent vertigo in a 73-year-old female was linked to a superior semicircular canal dehiscence. This condition, involving bone erosion, trapped otolith particles, causing refractory benign paroxysmal positional vertigo.
Area of Science:
- Neuroscience
- Otolaryngology
- Vestibular System
Background:
- Benign paroxysmal positional vertigo (BPPV) can be refractory to standard treatments.
- Superior semicircular canal dehiscence (SSCD) is a condition where bone erodes over the superior canal.
Observation:
- A 73-year-old female presented with persistent left anterior BPPV unresponsive to repositioning maneuvers and physical therapy.
- Audiovestibular assessment and high-resolution computed tomography revealed a 5.4 mm left anterior semicircular canal dehiscence.
Findings:
- Advanced imaging (T2-weighted, 3D labyrinthine sequences) showed a partially "auto-plugged" SSCD.
- Otolith particles were observed entrapped within the dehiscence, near the superior semicircular canal's cupula.
Implications:
- This case suggests a potential link between SSCD and refractory BPPV.
- Understanding this connection may lead to new diagnostic and therapeutic strategies for complex vestibular disorders.
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