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Superior semi-circular canal dehiscence syndrome: quantifying the effectiveness of treatment from the patient's perspective

Published online by Cambridge University Press:  01 December 2021

N Mehta ,
E Arram ,
M J Rouhani ,
L Dimitrov ,
H K Ubhi ,
S Khalil  and
S R Saeed
N Mehta*
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK University College London Ear Institute, UK evidENT, University College London Ear Institute, University College London, UK
E Arram
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
M J Rouhani
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
L Dimitrov
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK evidENT, University College London Ear Institute, University College London, UK National Institute of Health Research, University College London Hospitals Biomedical Research Centre, UK
H K Ubhi
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
S Khalil
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
S R Saeed
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK University College London Ear Institute, UK evidENT, University College London Ear Institute, University College London, UK National Institute of Health Research, University College London Hospitals Biomedical Research Centre, UK
*
Author for correspondence: Mr N Mehta, Royal National ENT and Eastman Dental Hospitals, 47–49 Huntley Street, LondonWC1E 6DG, UK E-mail: nishchaymehta@nhs.net Fax: +20 7837 8248
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Abstract

Background

Superior semi-circular canal dehiscence syndrome is a disorder characterised by auditory and vestibular symptoms that can significantly impact quality of life, and yet it has no disease-specific quality of life instrument.

Method

Thirty-six patients who underwent transmastoid superior semicircular canal resurfacing and plugging were included from an initial cohort of 60 surgically managed patients. A sub-cohort of 19 consecutive patients completed validated symptom and quality of life questionnaires before and after surgery. Of the 36 patients, 31 participated in a telephone semi-structured interview post-operatively.

Results

Following surgery, there was a statistically significant improvement in autophony index score (p = 0.02), symptom severity score (p < 0.001) and sound hypersensitivity (p = 0.01). Thematic analysis of telephone interviews suggested three main symptom themes: auditory hypersensitivity, dysequilibrium, headache and concentration difficulties. Dysequilibrium was found to persist post-operatively.

Conclusion

Surgery improves overall symptoms and quality of life. However, important symptom themes may be overlooked using the outcome measures that are currently available. A unified disease-specific outcome measure is urgently required to better understand the impact of symptoms and measure treatment effects.

Keywords

Patient Reported Outcome MeasuresSemicircular CanalsOtologic Surgical Procedures
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 9 , September 2022 , pp. 809 - 822
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr N Mehta takes responsibility for the integrity of the content of the paper

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