Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-19T14:43:28.287Z Has data issue: false hasContentIssue false
  • English
  • Français

Superior semi-circular canal dehiscence syndrome: quantifying the effectiveness of treatment from the patient's perspective

Published online by Cambridge University Press:  01 December 2021

N Mehta ,
E Arram ,
M J Rouhani ,
L Dimitrov ,
H K Ubhi ,
S Khalil  and
S R Saeed
N Mehta*
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK University College London Ear Institute, UK evidENT, University College London Ear Institute, University College London, UK
E Arram
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
M J Rouhani
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
L Dimitrov
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK evidENT, University College London Ear Institute, University College London, UK National Institute of Health Research, University College London Hospitals Biomedical Research Centre, UK
H K Ubhi
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
S Khalil
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
S R Saeed
Affiliation:
Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK University College London Ear Institute, UK evidENT, University College London Ear Institute, University College London, UK National Institute of Health Research, University College London Hospitals Biomedical Research Centre, UK
*
Author for correspondence: Mr N Mehta, Royal National ENT and Eastman Dental Hospitals, 47–49 Huntley Street, LondonWC1E 6DG, UK E-mail: nishchaymehta@nhs.net Fax: +20 7837 8248
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Superior semi-circular canal dehiscence syndrome is a disorder characterised by auditory and vestibular symptoms that can significantly impact quality of life, and yet it has no disease-specific quality of life instrument.

Method

Thirty-six patients who underwent transmastoid superior semicircular canal resurfacing and plugging were included from an initial cohort of 60 surgically managed patients. A sub-cohort of 19 consecutive patients completed validated symptom and quality of life questionnaires before and after surgery. Of the 36 patients, 31 participated in a telephone semi-structured interview post-operatively.

Results

Following surgery, there was a statistically significant improvement in autophony index score (p = 0.02), symptom severity score (p < 0.001) and sound hypersensitivity (p = 0.01). Thematic analysis of telephone interviews suggested three main symptom themes: auditory hypersensitivity, dysequilibrium, headache and concentration difficulties. Dysequilibrium was found to persist post-operatively.

Conclusion

Surgery improves overall symptoms and quality of life. However, important symptom themes may be overlooked using the outcome measures that are currently available. A unified disease-specific outcome measure is urgently required to better understand the impact of symptoms and measure treatment effects.

Keywords

Patient Reported Outcome MeasuresSemicircular CanalsOtologic Surgical Procedures
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 9 , September 2022 , pp. 809 - 822
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr N Mehta takes responsibility for the integrity of the content of the paper

References

Minor, L, Solomon, D, Zinreich, J, Zee, D. Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 1998;124:249–58CrossRefGoogle ScholarPubMed
Powell, H, Khalil, S, Saeed, S. Outcomes of transmastoid surgery for superior semicircular canal dehiscence syndrome. Otol Neurotol 2016;37:228–33CrossRefGoogle ScholarPubMed
Brantberg, K, Bergenius, J, Mendel, L, H W, Tribukait, A, Ygge, J. Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 2001;121:68–75Google ScholarPubMed
Manzari, L, Burgess, A, MacDougall, H, Curthoys, I. Enhanced otolithic function in semicircular canal dehiscence. Acta Otolaryngol 2011;131:107–12CrossRefGoogle ScholarPubMed
Zuniga, M, Janky, K, Nguyen, K, Welgampola, M, Carey, J. Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol 2013;34:121–6CrossRefGoogle Scholar
Belden, C, Weg, N, Minor, L, Zinreich, S. CT evaluation of bone dehiscence of the superior semicircular canal as a cause of sound- and/or pressure-induced vertigo. Radiology 2003;226:337–43CrossRefGoogle ScholarPubMed
Silverstein, H, Kartush, J, Parnes, L, Poe, D, Babu, S, Levenson, M et al. Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series. Am J Otolaryngol 2014;35:286–93CrossRefGoogle ScholarPubMed
Vlastarakos, P, Proikas, K, Tavoulari, E, Kikidis, D, Maragoudakis, P, Nikolopoulos, T. Efficacy assessment and complications of surgical management for superior semicircular canal dehiscence: a meta-analysis of published interventional studies. Eur Arch Otorhinolaryngol 2009;266:177–86CrossRefGoogle ScholarPubMed
Kirtane, M, Sharma, A, Satwalekar, D. Transmastoid repair of superior semicircular canal dehiscence. J Laryngol Otol 2009;123:225–9CrossRefGoogle ScholarPubMed
Minor, L. Superior canal dehiscence syndrome. Am J Otol 2000;21:9–19CrossRefGoogle ScholarPubMed
Shaia, W, Diaz, R. Evolution in surgical management of superior canal dehiscence syndrome. Curr Opin Otolaryngol Head Neck Surg 2013;21:497–502CrossRefGoogle ScholarPubMed
Amoodi, H, Makki, F, McNeil, M, Bance, M. Transmastoid resurfacing of superior semicircular canal dehiscence. 2020Google Scholar
Gioacchini, F, Alicandri-Ciufelli, M, Kaleci, S, Scarpa, A, Cassandro, E, Re, M. Outcomes and complications in superior semicircular canal dehiscence surgery: a systematic review. Laryngoscope 2016;126:1218–24CrossRefGoogle ScholarPubMed
Noij, K, Wong, K, Duarte, M, Masud, S, Dewyer, N, Herrmann, B et al. Audiometric and cVEMP thresholds show little correlation with symptoms in superior semicircular canal dehiscence syndrome. Otol Neurotol 2018;39:1153–62CrossRefGoogle ScholarPubMed
Jung, D, Lookabaugh, S, Owoc, M, McKenna, M, Lee, D. Dizziness is more prevalent than autophony among patients who have undergone repair of superior canal dehiscence. Otol Neurotol 2015;36:126–32CrossRefGoogle ScholarPubMed
Remenschneider, A, Owoc, M, Kozin, E, McKenna, M, Lee, D, Jung, D. Health utility improves after surgery for superior canal dehiscence syndrome. Otol Neurotol 2015;36:1695–701CrossRefGoogle ScholarPubMed
Crane, B, Minor, L, Carey, J. Superior canal dehiscence plugging reduces dizziness handicap. Laryngoscope 2008;118:1809–13CrossRefGoogle ScholarPubMed
Allsopp, T, Kim, A, Robbins, A, Page, J, Dornhoffer, J. Quality of life outcomes after transmastoid plugging of superior semicircular canal dehiscence. Am J Otolaryngol 2020;41:102287CrossRefGoogle ScholarPubMed
Crane, B, Lin, F, Minor, L, Carey, J. Improvement in autophony symptoms after superior canal dehiscence repair. Otol Neurotol 2010;31:140–6CrossRefGoogle ScholarPubMed
Nelting, M, Rienhoff, N, Hesse, G, Lamparter, U. The assessment of subjective distress related to hyperacusis with a self-rating questionnaire on hypersensitivity to sound. Laryngorhinootologie 2002;81:327–34CrossRefGoogle ScholarPubMed
Bläsing, L, Goebel, G, Flötzinger, U, Berthold, A, Kröner-Herwig, B. Hypersensitivity to sound in tinnitus patients: an analysis of a construct based on questionnaire and audiological data. Int J Audiol 2010;49:518–26CrossRefGoogle ScholarPubMed
Skevington, S, McCrate, F. Expecting a good quality of life in health: assessing people with diverse diseases and conditions using the WHOQOL-BREF. Health Expect 2012;15:49–62CrossRefGoogle ScholarPubMed
Castleberry, A, Nolen, A. Thematic analysis of qualitative research data: is it as easy as it sounds? Currents in pharmacy teaching & learning 2018;10:807–15CrossRefGoogle ScholarPubMed
Jacobson, G, Newman, C. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990;116:424–7CrossRefGoogle ScholarPubMed