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Trans-mastoid plugging of superior semicircular canal dehiscence: long-term follow-up

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

Abstract

Objective

To evaluate the long-term outcomes of trans-mastoid plugging of superior semicircular canal dehiscence (SSCD), focusing on complicated cases.

Methods

In this cohort study, we included all patients who underwent trans-mastoid plugging of SSCD between 2009 and 2019. We evaluated the symptoms (autophony, sound-/pressure-induced vertigo, disequilibrium, aural fullness and pulsatile tinnitus) before and 1 year after surgery in the medical records. We systematically assessed the current symptoms 6.2 ± 3 years postoperative (range 2.2–12.3 years) using questionnaires sent by post and validated by telephone interviews. We also documented any complications and the need for further procedures. We compared pure tone and speech audiometry before and 1 year after surgery. Finally, the degree of mastoid pneumatisation and mastoid tegmen anatomy were reviewed on preoperative CT scans.

Results

We included 24 ears in 23 patients. No complications were recorded, and none required a second procedure for SSCD. Following surgery, oscillopsia and Tullio phenomena resolved in all patients. Hyperacusis, autophony, and aural fullness were also settled in all patients except one. Balance impairment persisted to some degree in 35% of patients. No deterioration over the years was reported regarding the above symptoms. On average, bone conduction pure tone average pre- and 1 year postoperative were 13.7 ± 17 and 20.5 ± 18 dB, respectively (P = 0.002). Air bone gaps were reduced from 12.7 ± 8 to 5.9 ± 6 (P = 0.001). Two patients had a significant sclerotic mastoid, three had a prominent low-lying mastoid tegmen, and two had both. Anatomy had no effect on outcome.

Conclusion

Trans-mastoid plugging of SSCD is a reliable and effective technique which achieves long-lasting symptom control, even in cases with sclerotic mastoid or low-lying mastoid tegmen.

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Authors and Affiliations

  1. The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia

    Chanan Shaul, Stefan Weder, Adrian Dragovic, Jean-Marc Gerard & Robert J. S. Briggs

  2. Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Chanan Shaul

  3. Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Stefan Weder

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  1. Chanan Shaul
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  2. Stefan Weder
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  3. Adrian Dragovic
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  5. Robert J. S. Briggs
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Contributions

CS and SW designed and performed the research, analyzed the data and drafted the paper. They are equal contributors. AD conducted the study and assisted in data analysis. JMG helped design the research and write the manuscript. RB designed the study and drafted the paper. All authors contributed to the article and approved the submitted version.

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Correspondence to Chanan Shaul.

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Shaul, C., Weder, S., Dragovic, A. et al. Trans-mastoid plugging of superior semicircular canal dehiscence: long-term follow-up. Eur Arch Otorhinolaryngol 281, 67–74 (2024). https://doi.org/10.1007/s00405-023-08079-6

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