Transmastoid resurfacing of superior semicircular canal dehiscence

Abstract

Objectives/hypothesis: To describe a new and fast surgical technique in treating superior semicircular canal dehiscence syndrome by resurfacing the canal defect via the transmastoid approach without retraction of the whole temporal lobe and to demonstrate the clinical and audiologic results of the superior canal dehiscence repair. Superior semicircular canal dehiscence syndrome is a well-described pathology. Surgical procedures through the middle fossa approach to resurface the superior canal and transmastoid plugging are considered the main surgical therapeutic options for patients with debilitating symptoms. Both have drawbacks; plugging is invasive to the inner ear, and resurfacing requires a middle fossa approach.

Study design: Retrospective review.

Methods: Four patients presented with classic symptomatic semicircular canal dehiscence syndrome with radiographic confirmation of their dehiscence. The patients underwent the resurfacing procedure with a transmastoid approach.

Results: All four patients reported resolution of their symptoms. Audiograms documented some improvement in three subjects.

Conclusions: The transmastoid approach for resurfacing superior semicircular canal dehiscence is a safe and less-invasive technique than the standard middle fossa approach, which has many potential complications and requires much longer hospitalization. In our study, the surgeries were completed within 90 minutes, and patients stayed in the hospital only overnight.