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Spontaneous SSCD Auto-Plugging: Clinical, Electrophysiological and Radiological Evidence.

Pierre Reynard^1,2,3, Eugenia Mustea¹, Aïcha Ltaief-Boudrigua⁴

¹Department of Audiology and Otoneurological Explorations, Civil Hospitals of Lyon, 69003 Lyon, France.

Journal of Clinical Medicine

|November 27, 2025

Summary

Spontaneous auto-plugging in superior semicircular canal dehiscence (SSCD) can mimic surgical plugging. High-resolution MRI aids in identifying this under-recognized condition, guiding treatment decisions.

Keywords:

otic capsule dehiscence superior semicircular canal dehiscence superior semicircular canal dehiscence auto-plugging

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Area of Science:

Otolaryngology
Neuroimaging
Vestibular Science

Background:

Superior semicircular canal dehiscence (SSCD) involves a bony defect in the superior semicircular canal (SSC), causing auditory and vestibular issues.
Spontaneous auto-plugging, where dura mater obstructs the SSC, can mimic surgical canal plugging but is often overlooked.
This study investigates SSCD with spontaneous auto-plugging, detailing clinical, instrumental, and advanced MRI findings.

Purpose of the Study:

To report diverse clinical, instrumental, and 3D High Resolution MRI findings in patients with SSCD and spontaneous auto-plugging.
To characterize partial and complete auto-plugging using specific imaging classifications.
To evaluate the functional impact of auto-plugging on vestibular and auditory systems.

Main Methods:

Retrospective review of 11 patients with SSCD and suspected auto-plugging (dehiscence >4 mm).
Comprehensive neurotological assessment including audiometry, vestibular testing, and High-Resolution (HR) MRI with 3D labyrinthine reconstructions.
Classification of auto-plugging as partial (Canalis semicircularis superior depressus) or complete (Canalis semicircularis superior obturatus) based on HR MRI.

Main Results:

13 ears exhibited auto-plugging (6 partial, 7 complete) associated with SSCD.
The average SSCD size in auto-plugged ears was 5.5 mm.
Vestibular function (VHIT, VEMP) was mostly normal; HR MRI confirmed varying degrees of dural occlusion of the SSC.

Conclusions:

Spontaneous auto-plugging of the SSC is a plausible, under-recognized phenomenon that can functionally mimic surgical canal plugging.
Dedicated 3D labyrinthine MRI is crucial for detecting and characterizing auto-plugging.
Further research is needed to understand pathophysiology and optimize management strategies for SSCD patients.