J Am Acad Audiol 2020; 31(01): 076-082
DOI: 10.3766/jaaa.18076
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Symptoms, Audiometric and Vestibular Laboratory Findings, and Imaging in a Concurrent Superior Canal Dehiscence Syndrome and Vestibular Schwannoma: A Case Report

Doug Garrison
*   Department of Surgery, Division of Head and Neck Surgery and Communication Sciences, Duke University Hospital, Durham, NC
Laura Barth
*   Department of Surgery, Division of Head and Neck Surgery and Communication Sciences, Duke University Hospital, Durham, NC
David Kaylie
†   Department of Surgery, Division of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
Kristal Riska
†   Department of Surgery, Division of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
› Author Affiliations
Further Information

Publication History

12 October 2018

Publication Date:
25 May 2020 (online)



Dizziness is a common complaint that can arise from multiple systems in the body. Objective vestibular tests are used to understand the underlying function of the vestibular system and whether or not it may be contributing to the dizziness symptoms experienced by the patient. Even when comprehensive case history is consistent with an otologic etiology, audiometric and vestibular tests are ordered to objectively characterize inner ear function to help further refine the differential diagnoses and aid in guiding treatment options. Few reports in the literature describe audiometric and vestibular results in patients with multiple concurrent otologic etiologies.


This case provides a description of audiometric, vestibular, and imaging results in a case of concurrent bilateral superior canal dehiscence, right-sided vestibular schwannoma, and right-sided posterior canal benign paroxysmal positional vertigo. The patient’s symptoms and laboratory findings are described in detail and, where appropriate, highlight challenges that may arise in interpretation.

Research Design:

A case report.


The patient presented for evaluation of dizziness, asymmetric hearing loss, and autophony. Comprehensive audiometric evaluation shows asymmetric sensorineural hearing loss and an air-bone gap at 250 Hz in the right ear. Vestibular evaluation shows right caloric asymmetry along with abnormal cervical vestibular– and ocular vestibular–evoked myogenic potentials, with the left ear showing results consistent with the third-window pathology.


Comprehensive assessment of symptoms and critical thinking while performing testing are necessary when examining multiple concurrent otologic etiologies in a patient. Knowledge of anticipated test results and physiology may help the audiologist to synthesize results and make appropriate clinical recommendations as part of the multidisciplinary team.


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