Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T00:30:43.496Z Has data issue: false hasContentIssue false
  • English
  • Français

‘Soft reinforcement’ of the round window for superior semi-circular canal dehiscence syndrome

Published online by Cambridge University Press:  28 February 2020

A Gona  and
J S Phillips
A Gona*
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
J S Phillips
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
*
Author for correspondence: Mr Ajay Kumar Gona, Department of Otolaryngology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NorfolkNR4 7UY, UK E-mail: ajaygona@gmail.com Fax: +44 1603 287288
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Individuals with superior semi-circular canal syndrome often describe vestibular symptoms elicited by loud sounds, as well as other pressure-induced symptoms. They also often report other symptoms, including autophony, hyperacusis, cognitive dysfunction, spatial disorientation, anxiety and migraine headaches. Symptoms occur due to the presence of a ‘third window’ created by the dehiscence of the superior semi-circular canal. This case report describes a minimally invasive technique to provide soft reinforcement of the round window.

Case report

Our patient underwent a permeatal procedure whereby the tympanic membrane was raised to allow inspection of the middle ear. The round window niche was identified and the round window membrane was reinforced with fat. The mucosa of the bony meatus leading to the round window was then disrupted before the application of a double layer of perichondrium to allow further reinforcement.

Conclusion

The case provides support for the use of ‘soft reinforcement’ as a simple and effective technique to treat the symptoms of superior canal dehiscence syndrome.

Keywords

Superior Semicircular Canal Dehiscence SyndromeRound WindowEarHyperacusisVestibular Evoked Myogenic PotentialsTinnitus
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 4 , April 2020 , pp. 366 - 368
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr J S Phillips takes responsibility for the integrity of the content of the paper

References

Minor, LB, Solomon, D, Zinreich, JS, Zee, DS. Sound and/or pressure induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 1998;124:249–58CrossRefGoogle ScholarPubMed
Kutz, W. Semicircular canal dehiscence. In: Phillips, J, Erskine, S, eds. Landmark Papers in Otolaryngology. Oxford: Oxford University Press, 2018Google Scholar
Crane, B, Carey, J, Minor, L. Superior semicircular canal dehiscence syndrome. In: Brackmann, D, Shelton, C, Arriaga, MA, eds. Otologic Surgery, 4th edn. Philadelphia: Elsevier, 2015Google Scholar
Davey, S, Kelly-Morland, C, Phillips, JS, Nunney, I, Pawaroo, D. Assessment of superior semicircular canal thickness with advancing age. Laryngoscope 2015;125:1940–5CrossRefGoogle ScholarPubMed
Silverstein, H, Vas Ess, M. Complete round window niche occlusion for superior semicircular canal dehiscence syndrome: a minimally invasive approach. Ear Nose Throat J 2009;88:1042–56CrossRefGoogle ScholarPubMed
Silverstein, H, Kartush, JM, Parnes, LS, Poe, DS, Babu, SC, Levenson, MJ et al. Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series. Am J Otolaryngol 2014;35:286–93CrossRefGoogle ScholarPubMed
Nikkar-Esfahani, A, Whelan, D, Banerjee, A. Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence syndrome. J Laryngol Otol 2013;127:705–7CrossRefGoogle ScholarPubMed
Succar, EF, Manickam, PV, Wing, S, Walter, J, Greene, JS, Azeredo, WJ. Round window plugging in the treatment of superior semicircular canal dehiscence. Laryngoscope 2018;128:1445–52CrossRefGoogle ScholarPubMed