J Neurol Surg B Skull Base 2015; 76(06): 421-425
DOI: 10.1055/s-0035-1551667
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Clinical Characteristics of Posterior and Lateral Semicircular Canal Dehiscence

Marko Spasic
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Andy Trang
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Lawrance K. Chung
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Nolan Ung
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Kimberly Thill
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Golmah Zarinkhou
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Quinton S. Gopen
2   Division of Otolaryngology Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
,
Isaac Yang
1   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
3   UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California, United States
› Author Affiliations
Further Information

Publication History

06 June 2014

08 March 2015

Publication Date:
29 May 2015 (online)

Abstract

The objective of this study was to evaluate the characteristic symptoms of and treatments for lateral semicircular canal dehiscence (LSCD) and posterior semicircular canal dehiscence (PSCD) and its proposed mechanism. A dehiscence acquired in any of the semicircular canals may evoke various auditory symptoms (autophony and inner ear conductive hearing loss) or vestibular symptoms (vertigo, the Tullio phenomenon, and Hennebert sign) by creating a “third mobile window” in the bone that enables aberrant communication between the inner ear and nearby structures. A PubMed search was performed using the keywords lateral, posterior, and semicircular canal dehiscence to identify all relevant cases. Our data suggest that PSCD, although clinically rare, is most likely associated with a high-riding jugular bulb and fibrous dysplasia. Patients may experience auditory manifestations that range from mild conductive to extensive sensorineural hearing loss. LSCD is usually associated with chronic otitis media with cholesteatoma.

 
  • References

  • 1 Chien WW, Carey JP, Minor LB. Canal dehiscence. Curr Opin Neurol 2011; 24 (1) 25-31
  • 2 Amoodi HA, Makki FM, McNeil M, Bance M. Transmastoid resurfacing of superior semicircular canal dehiscence. Laryngoscope 2011; 121 (5) 1117-1123
  • 3 Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005; 115 (10) 1717-1727
  • 4 Friedland DR, Michel MA. Cranial thickness in superior canal dehiscence syndrome: implications for canal resurfacing surgery. Otol Neurotol 2006; 27 (3) 346-354
  • 5 Minor LB, Carey JP, Cremer PD, Lustig LR, Streubel SO, Ruckenstein MJ. Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Otol Neurotol 2003; 24 (2) 270-278
  • 6 Gopen Q, Zhou G, Poe D, Kenna M, Jones D. Posterior semicircular canal dehiscence: first reported case series. Otol Neurotol 2010; 31 (2) 339-344
  • 7 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 (3) 249-258
  • 8 Merchant SN, Rosowski JJ. Conductive hearing loss caused by third-window lesions of the inner ear. Otol Neurotol 2008; 29 (3) 282-289
  • 9 Stimmer H, Hamann KF, Zeiter S, Naumann A, Rummeny EJ. Semicircular canal dehiscence in HR multislice computed tomography: distribution, frequency, and clinical relevance. Eur Arch Otorhinolaryngol 2012; 269 (2) 475-480
  • 10 Krombach GA, DiMartino E, Schmitz-Rode T , et al. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence. Eur Radiol 2003; 13 (6) 1444-1450
  • 11 Brantberg K, Bergenius J, Mendel L, Witt H, Tribukait A, Ygge J. Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 2001; 121 (1) 68-75
  • 12 Erdogan N, Songu M, Akay E , et al. Posterior semicircular canal dehiscence in asymptomatic ears. Acta Otolaryngol 2011; 131 (1) 4-8
  • 13 Zhang LC, Sha Y, Dai CF. Another etiology for vertigo due to idiopathic lateral semicircular canal bony defect. Auris Nasus Larynx 2011; 38 (3) 402-405
  • 14 Cremer PD, Minor LB, Carey JP, Della Santina CC. Eye movements in patients with superior canal dehiscence syndrome align with the abnormal canal. Neurology 2000; 55 (12) 1833-1841
  • 15 Mikulec AA, Poe DS. Operative management of a posterior semicircular canal dehiscence. Laryngoscope 2006; 116 (3) 375-378
  • 16 McCall AA, Curtin HD, McKenna MJ. Posterior semicircular canal dehiscence arising from temporal bone fibrous dysplasia. Otol Neurotol 2010; 31 (9) 1516-1517
  • 17 Chen EY, Paladin A, Phillips G , et al. Semicircular canal dehiscence in the pediatric population. Int J Pediatr Otorhinolaryngol 2009; 73 (2) 321-327
  • 18 Rosowski JJ, Songer JE, Nakajima HH, Brinsko KM, Merchant SN. Clinical, experimental, and theoretical investigations of the effect of superior semicircular canal dehiscence on hearing mechanisms. Otol Neurotol 2004; 25 (3) 323-332
  • 19 Hirvonen TP, Carey JP, Liang CJ, Minor LB. Superior canal dehiscence: mechanisms of pressure sensitivity in a chinchilla model. Arch Otolaryngol Head Neck Surg 2001; 127 (11) 1331-1336
  • 20 da Cunha Ferreira S, de Melo Tavares de Lima MA. Superior canal dehiscence syndrome. Braz J Otorhinolaryngol 2006; 72 (3) 414-418
  • 21 Yagi T, Kamura E, Shitara A. Three-dimensional analysis of pressure nystagmus in labyrinthine fistulae. Acta Otolaryngol 1999; 119 (2) 150-153
  • 22 Minor LB, Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N. Symptoms and signs in superior canal dehiscence syndrome. Ann N Y Acad Sci 2001; 942: 259-273
  • 23 Mikulec AA, McKenna MJ, Ramsey MJ , et al. Superior semicircular canal dehiscence presenting as conductive hearing loss without vertigo. Otol Neurotol 2004; 25 (2) 121-129
  • 24 Manzari L. Multiple dehiscences of bony labyrinthine capsule. A rare case report and review of the literature. Acta Otorhinolaryngol Ital 2010; 30 (6) 317-320
  • 25 Wadin K, Thomander L, Wilbrand H. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation. Acta Radiol Diagn (Stockh) 1986; 27 (6) 629-636
  • 26 Vanspauwen R, Salembier L, Van den Hauwe L, Parizel P, Wuyts FL, Van de Heyning PH. Posterior semicircular canal dehiscence: value of VEMP and multidetector CT. B-ENT 2006; 2 (3) 141-145
  • 27 Di Lella F, Falcioni M, Piazza P. Dehiscence of posterior semicircular canal. Otol Neurotol 2007; 28 (2) 280-281
  • 28 Brantberg K, Bagger-Sjöbäck D, Mathiesen T, Witt H, Pansell T. Posterior canal dehiscence syndrome caused by an apex cholesteatoma. Otol Neurotol 2006; 27 (4) 531-534
  • 29 Paladin AM, Phillips GS, Raske ME, Sie KC. Labyrinthine dehiscence in a child. Pediatr Radiol 2008; 38 (3) 348-350
  • 30 Cremer PD, Migliaccio AA, Pohl DV , et al. Posterior semicircular canal nystagmus is conjugate and its axis is parallel to that of the canal. Neurology 2000; 54 (10) 2016-2020
  • 31 Zhang YB, Dai CF, Sha Y. Sound-induced vertigo due to bone dehiscence of the lateral semicircular canal. Eur Arch Otorhinolaryngol 2010; 267 (8) 1319-1321
  • 32 Bassim MK, Patel KG, Buchman CA. Lateral semicircular canal dehiscence. Otol Neurotol 2007; 28 (8) 1155-1156
  • 33 Hakuba N, Hato N, Shinomori Y, Sato H, Gyo K. Labyrinthine fistula as a late complication of middle ear surgery using the canal wall down technique. Otol Neurotol 2002; 23 (6) 832-835
  • 34 Chu H, Chung WH. Images in clinical medicine. Perilymph fistula test. N . Engl J Med 2012; 366 (4) e8
  • 35 Jang CH, Merchant SN. Histopathology of labyrinthine fistulae in chronic otitis media with clinical implications. Am J Otol 1997; 18 (1) 15-25
  • 36 Chen Z, Dongzhen WY, Wu Y , et al. Surgical treatment of labyrinthine fistula caused by cholesteatoma with semicircular canal occlusion. Acta Otolaryngol 2010; 130 (1) 75-78