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How I Do It: Repair of Superior Semicircular Canal Dehiscence and Near-Dehiscence
Kevin Jer V David1, Mary Ellen C Perez2, Charlotte M Chiong
1Department of Otorhinolaryngology-Head and Neck Surgery, Philippine General Hospital, Metro Manila, Philippines.
Objective:
This study aims to report the clinical characteristics of patients with superior semicircular canal dehiscence and near-dehiscence and to evaluate the outcomes of repair using a novel technique: middle cranial fossa minicraniotomy with combined plugging and resurfacing using a bone plate enveloped in fascia.
Study Design:
Retrospective case series.
Setting:
Tertiary hospital in the Philippines.
Patients:
Forty patients, including 28 cases of superior canal dehiscence syndrome (SCDS) and 12 cases of superior semicircular canal thinning or near-dehiscence.
Interventions:
Surgical repair of superior semicircular canal dehiscence or near-dehiscence.
Main Outcome Measures:
Symptomatic relief and improvement in vestibular evoked myogenic potential (VEMP) findings, defined as either an increase in VEMP thresholds or a reduction in VEMP amplitude.
Results:
Symptomatic relief was achieved in all 40 patients, with 88% demonstrating either increased VEMP thresholds or reduced amplitudes postoperatively. No major complications were noted.
Conclusions:
The middle cranial fossa approach, combining plugging and resurfacing of the superior semicircular canal with a bone plate and fascia, appears to be a safe and effective technique for treating both SCDS and near-dehiscence.
