Hostname: page-component-848d4c4894-xfwgj Total loading time: 0 Render date: 2024-06-25T02:08:23.853Z Has data issue: false hasContentIssue false

Surgical treatment of posterior semicircular canal dehiscence syndrome caused by jugular diverticulum

Published online by Cambridge University Press:  17 July 2012

H W Lim
Affiliation:
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
H J Park
Affiliation:
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
J H Jung
Affiliation:
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
J W Chung*
Affiliation:
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
*
Address for correspondence: Dr Jong Woo Chung, Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap 2-dong, Songpa-gu, Seoul 138–736, South Korea Fax: +82 2 489 2773 E-mail: jwchung@amc.seoul.kr

Abstract

Objective:

We report a rare case of posterior semicircular canal dehiscence caused by a jugular diverticulum, and we describe its surgical treatment using a dehiscence resurfacing manoeuvre.

Method:

The clinical findings, surgical procedure and outcomes are presented.

Results:

A 66-year-old man presented with disequilibrium, sound-induced vertigo, a reduced ocular vestibular evoked myogenic potential threshold, and pressure-induced vertical and torsional nystagmus. Computed tomography revealed a right posterior semicircular canal dehiscence caused by a diverticulum of the jugular bulb. The defect in the posterior semicircular canal was localised and resurfaced with bone paté, temporalis muscle fascia and conchal cartilage, under direct visualisation. Post-operatively, the patient's symptoms disappeared and his ocular vestibular evoked myogenic potential threshold normalised.

Conclusion:

This case illustrates that posterior semicircular canal dehiscence can be surgically managed by resurfacing the defect site via a transmastoid approach.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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.)

References

1Minor, LB, Solomon, D, Zinreich, JS, Zee, DS. 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
2Brantberg, K, Bagger-Sjoback, D, Mathiesen, T, Witt, H, Pansell, T. Posterior canal dehiscence syndrome caused by an apex cholesteatoma. Otol Neurotol 2006;27:531–4CrossRefGoogle ScholarPubMed
3Gopen, Q, Zhou, G, Poe, D, Kenna, M, Jones, D. Posterior semicircular canal dehiscence: first reported case series. Otol Neurotol 2010;31:339–44CrossRefGoogle ScholarPubMed
4McCall, AA, Curtin, HD, McKenna, MJ. Posterior semicircular canal dehiscence arising from temporal bone fibrous dysplasia. Otol Neurotol 2010;31:1516–17CrossRefGoogle ScholarPubMed
5Di Lella, F, Falcioni, M, Piazza, P. Dehiscence of posterior semicircular canal. Otol Neurotol 2007;28:280–1CrossRefGoogle ScholarPubMed
6Minor, LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 2005;115:1717–27CrossRefGoogle ScholarPubMed
7Mikulec, AA, Poe, DS. Operative management of a posterior semicircular canal dehiscence. Laryngoscope 2006;116:375–8CrossRefGoogle ScholarPubMed
8Carey, JP, Migliaccio, AA, Minor, LB. Semicircular canal function before and after surgery for superior canal dehiscence. Otol Neurotol 2007;28:356–64CrossRefGoogle ScholarPubMed
9Parnes, LS. Update on posterior canal occlusion for benign paroxysmal positional vertigo. Otolaryngol Clin North Am 1996;29:333–42CrossRefGoogle ScholarPubMed
10Welgampola, MS, Migliaccio, AA, Myrie, OA, Minor, LB, Carey, JP. The human sound-evoked vestibulo-ocular reflex and its electromyographic correlate. Clin Neurophysiol 2009;120:158–66CrossRefGoogle ScholarPubMed
11Otto, KJ, Hudgins, PA, Abdelkafy, W, Mattox, DE. Sigmoid sinus diverticulum: a new surgical approach to the correction of pulsatile tinnitus. Otol Neurotol 2007;28:4853CrossRefGoogle Scholar