TY - JOUR
T1 - Current Trends, Controversies, and Future Directions in the Evaluation and Management of Superior Canal Dehiscence Syndrome
AU - Eberhard, Kristine Elisabeth
AU - Chari, Divya A.
AU - Nakajima, Hideko Heidi
AU - Klokker, Mads
AU - Cayé-Thomasen, Per
AU - Lee, Daniel J.
N1 - Funding Information:
Funding was provided by the William Demant Foundation and Copenhagen Hearing and Balance Centre at the Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital - Rigshospitalet (KE); and by NIH/NIDCD R01 DC004798 (HN).
Funding Information:
We would like to thank Yew Song Cheng for the schematic illustrations and figures. Funding. Funding was provided by the William Demant Foundation and Copenhagen Hearing and Balance Centre at the Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital - Rigshospitalet (KE); and by NIH/NIDCD R01 DC004798 (HN).
Publisher Copyright:
© Copyright © 2021 Eberhard, Chari, Nakajima, Klokker, Cayé-Thomasen and Lee.
PY - 2021/4/6
Y1 - 2021/4/6
N2 - Patients with superior canal dehiscence syndrome (SCDS) can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of the superior semicircular canal (SSC). Over the past two decades, advances in diagnostic techniques have raised the awareness of SCDS and treatment approaches have been refined to improve patient outcomes. However, a number of challenges remain. First, there is currently no standardized clinical testing algorithm for quantifying the effects of superior canal dehiscence (SCD). SCDS mimics a number of common otologic disorders and established metrics such as supranormal bone conduction thresholds and vestibular evoked myogenic potential (VEMP) measurements; although useful in certain cases, have diagnostic limitations. Second, while high-resolution computed tomography (CT) is the gold standard for the detection of SCD, a bony defect does not always result in signs and symptoms. Third, even when SCD repair is indicated, there is a lack of consensus about nomenclature to describe the SCD, ideal surgical approach, specific repair techniques, and type of materials used. Finally, there is no established algorithm in evaluation of SCDS patients who fail primary repair and may be candidates for revision surgery. Herein, we will discuss both contemporary and emerging diagnostic approaches for patients with SCDS and highlight challenges and controversies in the management of this unique patient cohort.
AB - Patients with superior canal dehiscence syndrome (SCDS) can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of the superior semicircular canal (SSC). Over the past two decades, advances in diagnostic techniques have raised the awareness of SCDS and treatment approaches have been refined to improve patient outcomes. However, a number of challenges remain. First, there is currently no standardized clinical testing algorithm for quantifying the effects of superior canal dehiscence (SCD). SCDS mimics a number of common otologic disorders and established metrics such as supranormal bone conduction thresholds and vestibular evoked myogenic potential (VEMP) measurements; although useful in certain cases, have diagnostic limitations. Second, while high-resolution computed tomography (CT) is the gold standard for the detection of SCD, a bony defect does not always result in signs and symptoms. Third, even when SCD repair is indicated, there is a lack of consensus about nomenclature to describe the SCD, ideal surgical approach, specific repair techniques, and type of materials used. Finally, there is no established algorithm in evaluation of SCDS patients who fail primary repair and may be candidates for revision surgery. Herein, we will discuss both contemporary and emerging diagnostic approaches for patients with SCDS and highlight challenges and controversies in the management of this unique patient cohort.
KW - craniotomy
KW - diagnostic
KW - SCD
KW - semicircular canal dehiscence
KW - SSCD
KW - superior canal dehiscence
KW - third window syndrome
KW - transmastoid
U2 - 10.3389/fneur.2021.638574
DO - 10.3389/fneur.2021.638574
M3 - Review
C2 - 33889125
AN - SCOPUS:85104590424
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 638574
ER -