Age and Gender Effects on the Repair of Superior Semicircular Canal Dehiscence through Middle Cranial Fossa Approach

Background Superior semicircular canal dehiscence (SSCD) is caused by a fistula in the arcuate eminence, causing vestibular and auditory disturbances. SSCD repair is currently performed through a middle cranial fossa (MCF) approach, showing high rates of symptom resolution. Here, the authors summarize outcomes for the MCF approach.

Methods A strategic Boolean search was conducted through PubMed. Full English text articles for SSCD patients surgically treated via an MCF approach were included. Patient characteristics and outcomes were extracted. A total of 348 patients were identified, of which 12 studies including 102 total patients were amenable to quantitative analysis.

Results On average, 89.5% (SD: 10.5%; range: 72–100%) of patients achieved partial or full resolution of symptoms after MCF surgery. Relative to males, females were more likely to show significant improvement in autophony (odds ratio [OR] = 3.74, 95% confidence interval [CI] = [1.35, 10.34], p = 0.0136) and tinnitus (OR = 4.77, [1.37, 16.61], p = 0.0189). In male patients, age was positively correlated with worsening imbalance after surgery (r [25] = 0.48, p = 0.011). In both men and women, age was negatively associated with worsening aural fullness after surgery (r (49) = −0.30, p = 0.0347). Among patients with bilateral SSCD, unilateral resurfacing improved tinnitus (OR = 10.55 [2.42, 45.98], p = 0.0009).

Conclusion SSCD repair through an MCF approach is safe and effective for resolving auditory and vestibular symptoms. Gender- and age-associated factors may influence patient outcomes. Studies involving larger cohorts and longer follow-up times are necessary to validate these findings.