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Evaluation of the transmastoid plugging approach for superior semicircular canal dehiscences: a retrospective series of 30 ears

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The classical surgical approach for superior semicircular canal dehiscences (SSCD) is via the extradural middle cranial fossa. This pathway is used to resurface or to plug the SSC. In this paper, we present long-term data on an alternative route: the transmastoid pathway. The predictive factors for a successful surgery are equally presented in this paper.

Methods

Thirty reports of patients operated between September 2007 to January 2020 were analysed. SSCD was confirmed by the association of concordant complaints, audiometric data, cervical vestibular evoked myogenic potentials (cVEMP) responses and computerized tomography findings. Before and after surgery, the following factors were analysed: auditory and vestibular subjective symptoms, Tullio phenomenon, pure-tone audiometry thresholds for air and bone conduction, air–bone gap, cVEMP threshold, and computerized tomography data, for instance the size of the dehiscence.

Results

The follow-up is 21 months on average. The transmastoid approach significantly improves all symptoms (although there were less probing results for the vestibular symptoms). Objectively, we can observe, a closure of the audiometric air–bone gap on the low frequencies and an improvement in the cVEMP. The only correlation that was identified was between the preoperative cVEMP results and the postoperative air conduction.

Conclusions

The originality of this study is the long postoperative follow-up. It allowed us to evaluate the symptoms in the long term and to determine a predictive factor of postoperative complication, which has not yet been described until today.The transmastoid plugging technique is safe and effective. Additional long-term data with a larger cohort are needed to confirm our results and correlation studies.

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Availability of data and materials

All data and material are available.

Abbreviations

ABG:

Air–bone gap

BC:

Bone conduction

BPPV:

Benign paroxysmal positional vertigo

CT:

Computerized tomography

CBCT:

Cone beam CT

CSF:

Cerebrospinal fluid

cVEMP:

Cervical vestibular evoked myogenic potential

DVT:

Digital volume tomography

ICU:

Intensive care unit

FIESTA:

Fast imaging employing steady-state acquisition

MRI:

Magnetic resonance imaging

oVEMP:

Ocular vestibular evoked myogenic potential

PPPD:

Persistent postural perceptual dizziness

PPV:

Positive predictive value

PTA:

Pure-tone average

SSC:

Superior semicircular canal

SSCD:

Superior semicircular canal dehiscence

VEMP:

Vestibular evoked myogenic potential

VHIT:

Video head impulse test

VNG:

Videonystagmography

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Acknowledgements

I would like to thank Robert Mills for his availability and for commenting on the original manuscript.

Funding

No funds, Grants, or other support was received. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology-Head and Neck and Skull Base Surgery, Sint Augustinus Hospital, Antwerp, Belgium

    Catherine Blaivie & Thomas Somers

  2. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, St Luc University Hospital, Brussels, Belgium

    Guillaume Gersdorff, Naïma Deggouj & Thomas Somers

  3. Department of Radiology, GZA Hospitals, Antwerp, Belgium

    Bert de Foer

  4. Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium

    Florent Wyckmans

  5. ENT Department, Saint-Luc Hospital, Avenue Hippocrate 10, 1200, Bruxelles, Belgium

    Guillaume Gersdorff

Authors
  1. Guillaume Gersdorff
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  2. Catherine Blaivie
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  3. Bert de Foer
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  4. Naïma Deggouj
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  5. Florent Wyckmans
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  6. Thomas Somers
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Contributions

GG and TS wrote the original manuscript followed by all co-authors commenting on the original manuscript and approved the final work. FW handled the database and did the statistical analyses.

Corresponding author

Correspondence to Guillaume Gersdorff.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

This study is a retrospective and ethically approved Research. (Reference: 2021/21OCT/430; Belgian registration number: B 403).

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All patients give their verbal consented to participate this study.

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Verbal informed consent was obtained prior to the submission.

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Gersdorff, G., Blaivie, C., de Foer, B. et al. Evaluation of the transmastoid plugging approach for superior semicircular canal dehiscences: a retrospective series of 30 ears. Eur Arch Otorhinolaryngol 279, 4861–4869 (2022). https://doi.org/10.1007/s00405-022-07316-8

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  • DOI: https://doi.org/10.1007/s00405-022-07316-8

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