Superior Canal Dehiscence Length and Location Influences Clinical Presentation and Audiometric and Cervical Vestibular-Evoked Myogenic Potential Testing

Marlien E.F. Niesten, Leena M. Hamberg, Joshua B. Silverman, Kristina V. Lou, Andrew A. McCall, Alanna Windsor, Hugh D. Curtin, Barbara S. Herrmann, Wilko Grolman, Hideko H. Nakajima, Daniel J. Lee

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Superior canal dehiscence (SCD) is caused by an absence of bony covering of the arcuate eminence or posteromedial aspect of the superior semicircular canal. However, the clinical presentation of SCD syndrome varies considerably, as some SCD patients are asymptomatic and others have auditory and/or vestibular complaints. In order to determine the basis for these observations, we examined the association between SCD length and location with: (1) auditory and vestibular signs and symptoms; (2) air conduction (AC) loss and air-bone gap (ABG) measured by pure-tone audiometric testing, and (3) cervical vestibular-evoked myogenic potential (cVEMP) thresholds. 104 patients (147 ears) underwent SCD length and location measurements using a novel method of measuring bone density along 0.2-mm radial CT sections. We found that patients with auditory symptoms have a larger dehiscence (median length: 4.5 vs. 2.7 mm) with a beginning closer to the ampulla (median location: 4.8 vs. 6.4 mm from ampulla) than patients with no auditory symptoms (only vestibular symptoms). An increase in AC threshold was found as the SCD length increased at 250 Hz (95% CI: 1.7-4.7), 500 Hz (95% CI: 0.7-3.5) and 1,000 Hz (95% CI: 0.0-2.5), and an increase in ABG as the SCD length increased at 250 Hz (95% CI: 2.0-5.3), 500 Hz (95% CI: 1.6-4.6) and 1,000 Hz (95% CI: 1.3-3.3) was also seen. Finally, a larger dehiscence was associated with lowered cVEMP thresholds at 250 Hz (95% CI: -4.4 to -0.3), 500 Hz (95% CI: -4.1 to -1.0), 750 Hz (95% CI: -4.2 to -0.7) and 1,000 Hz (95% CI: -3.6 to -0.5) and a starting location closer to the ampulla at 250 Hz (95% CI: 1.3-5.1), 750 Hz (95% CI: 0.2-3.3) and 1,000 Hz (95% CI: 0.6-3.5). These findings may help to explain the variation of signs and symptoms seen in patients with SCD syndrome.

Original languageEnglish (US)
Pages (from-to)97-105
Number of pages9
JournalAudiology and Neuro-Otology
Volume19
Issue number2
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Audiometry
  • Cervical vestibular-evoked myogenic potential
  • Length, auditory
  • Superior canal dehiscence, location
  • Superior canal dehiscence, size

ASJC Scopus subject areas

  • Physiology
  • Otorhinolaryngology
  • Sensory Systems
  • Speech and Hearing

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