Introduction: Superior semicircular canal dehiscence (SSCD) is characterized by a fistula between
the superior semicircular canal with the skull base of the temporal fossa. Hearing
loss, pulsatile tinnitus, chronic disequilibrium, and autophony are commonly elicited
as aberrant communication occurs between the inner ear and its surrounding structures.
Optimal treatment modality for this disease is not yet fully elucidated. In this study,
we analyze the largest reported series of SSCD surgically treated patients.
Methods: Patients were retrospectively reviewed and evaluated for surgical treatment of SSCD
at UCLA from 2011–2013. All patients were treated by the same surgical team with a
middle fossa craniotomy to resurface the skull base temporal floor for SSCD repair.
Symptomatic improvements associated with different clinical factors and demographics
were analyzed with a Chi-squared test. P values of less than 0.05 were considered
statistically significant.
Results: A total of 8 patients, 3 male (37.5%) and 5 female (62.5%) with a mean age of 54.4
years, presented with SSCD. 3 cases were located on the left while 5 were located
on the right. All 8 patients were treated with a middle fossa craniotomy for temporal
floor skull base repair and had an average follow up of 18 months ± 3 months. 87.5%
of treated patients reported dramatic improvements of their clinical symptoms whereas
12.5% reported slight improvement in clinical symptoms after surgical intervention
(p = .03). Of the patients with significantly improved symptoms, none have reported
a recurrence of their symptoms.
Conclusion: Our data suggests that middle fossa craniotomy is associated with significant symptom
improvement in patients with SSCD. Age and gender were not predictive of improved
patient outcome. Older patients treated with surgery were similarly associated with
symptom improvement as younger patients. Future studies with longer term follow up
can further elucidate the permanent efficacy of this treatment for SSCD.
