J Neurol Surg B Skull Base 2017; 78(S 01): S1-S156
DOI: 10.1055/s-0037-1600701
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

The Prevalence of Superior Semicircular Canal Dehiscence in Patients with Cerebrospinal Fluid Otorrhea with and without Mastoid Encephalocele

Melissa S. Oh
1   Emory University School of Medicine, Atlanta, Georgia, United States
,
Esther X. Vivas
2   Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, United States
,
Patricia A. Hudgins
3   Department of Radiology, Emory University School of Medicine, Atlanta, Georgia, United States
,
Douglas E. Mattox
2   Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, United States
› Author Affiliations
Further Information

Publication History

Publication Date:
02 March 2017 (online)

 

Background: Mastoid meningoencephalocele and superior semicircular canal dehiscence (SSCD) are both relatively uncommon pathologies, but they may occur concomitantly and possibly share a common etiology. Limited studies investigating the relationship between mastoid encephalocele and SSCD are available.

Objective: To evaluate for an association between cerebrospinal fluid (CSF) otorrhea with and without mastoid encephalocele and SSCD.

Study Design: Retrospective case series with chart and imaging review.

Setting: University-affiliated tertiary center.

Subjects and Methods: A chart review was conducted of all patients who have had primary surgery for CSF otorrhea or encephalocele at our institution from 2008 to 2016. Seventy-three patients matched the inclusion criteria. The mean age was 55.5 years at the time of surgery, and 77% of patients were female. Patient charts were reviewed to confirm CSF otorrhea, encephalocele, and SSCD based on surgical documentation. High-resolution CT scans were reviewed to assess superior semicircular canal roof integrity.

Results: Of the 57 patients who had a confirmed encephalocele, 18 (32%) had concurrent dehiscence of the superior semicircular canal. Sixteen patients were treated for CSF otorrhea, of which 2 (13%) also had SSCD. In summary, 20 patients (27%) of those with CSF otorrhea with or without encephalocele had concurrent dehiscence of the superior canal.

Conclusion: The prevalence of SSCD in patients who have a history of CSF otorrhea with and without encephalocele was found to be 32% and 13%, respectively. Based on these preliminary findings, this dehiscence may be acquired. Because we speculate that SSCD and encephalocele may occur together, pre-operative knowledge of SSCD in patients with mastoid encephalocele or CSF otorrhea is important to possibly avoid or reduce surgical risk during encephalocele repair. Additionally, inquiry of SSCD in symptomatic patients may also reduce the number of surgeries.