Semicircular canal dehiscence

Classification according to ICD-10
H83.8	Other specified diseases of the inner ear
ICD-10 online (WHO version 2019)

Semicircular canal dehiscence , which can cause hearing and balance disorders, is a rare disease that was first described in 1998 by a group led by Lloyd Minor at Johns Hopkins University in Baltimore , USA .

The causes for this clinical picture are the thinning or complete disappearance of the bony covering of the upper semicircular canal in the inner ear . This may be due to an external physical influence, although there is also some evidence of a genetic predisposition. This defect can be detected with the help of computed tomography (CT) by imaging the affected area of the temporal bone. However, it has been found that this procedure gave many false positive results. 581 CT scans showed a frequency of 4%, while it was only 0.5% in 1000 histological examinations. However, CT scans are important in distinguishing between semicircular canal dehiscence and Meniere's disease .

Organ of balance and hearing. Semicircular canals on the left.

Once the diagnosis has been made, there are currently two surgical options: the missing layer of bone is replaced or a plug is placed in the semicircular canal, which is stuck to a layer of bone.

Symptoms

Semicircular canal dehiscence can affect both hearing and balance to varying degrees.

Autophony : your own voice or other body noises (e.g. heartbeat, eye movements, chewing noises, footsteps) are perceived louder than normal
Dizziness : often aggravated by noise
Tullio phenomenon - nystagmus (eye movements) and dizziness triggered by sounds of a certain frequency and / or volume in the affected ear and / or changes in pressure
pulse synchronous oscillopsia
Low frequency hearing loss
in some cases semicircular canal dehiscence causes chronic imbalance
Sensation of pressure in the affected ear
pulse synchronous tinnitus

Proper diagnosis of this disease is important in order to be able to clearly distinguish it from other difficult to diagnose diseases.

literature

A. Yew, G. Zarinkhou, M. Spasic, A. Trang, Q. Gopen, I. Yang: Characteristics and management of superior semicircular canal dehiscence. In: Journal of neurological surgery. Part B, skull base. Volume 73, number 6, December 2012, ISSN 2193-6331 , pp. 365-370, doi : 10.1055 / s-0032-1324397 , PMID 24294552 , PMC 3578588 (free full text) (review).
WW Chien, JP Carey, LB Minor: Canal dehiscence. In: Current Opinion in Neurology . Volume 24, Number 1, February 2011, ISSN 1473-6551 , pp. 25-31, doi : 10.1097 / WCO.0b013e328341ef88 , PMID 21124219 (review).

Web links

Timothy C. Hain: Superior Canal Dehiscence , Chicago Dizziness and Hearing website : http://www.dizziness-and-balance.com/disorders/unilat/scd.htm

Individual evidence

↑ LB Minor, D. Solomon, JS Zinreich, DS Zee: Sound- and / or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. In: Archives of Otolaryngology - Head & Neck Surgery. Volume 124, Number 3, March 1998, ISSN 0886-4470 , pp. 249-258, PMID 9525507 .
↑ A. Yew, G. Zarinkhou, M. Spasic, A. Trang, Q. Gopen, I. Yang: Characteristics and management of superior semicircular canal dehiscence. In: Journal of neurological surgery. Part B, skull base. Volume 73, number 6, December 2012, ISSN 2193-6331 , pp. 365-370, doi : 10.1055 / s-0032-1324397 , PMID 24294552 , PMC 3578588 (free full text) (review)

[PMID9525507-1] LB Minor, D. Solomon, JS Zinreich, DS Zee: Sound- and / or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. In: Archives of Otolaryngology - Head & Neck Surgery. Volume 124, Number 3, March 1998, ISSN 0886-4470 , pp. 249-258, PMID 9525507 .

[2] A. Yew, G. Zarinkhou, M. Spasic, A. Trang, Q. Gopen, I. Yang: Characteristics and management of superior semicircular canal dehiscence. In: Journal of neurological surgery. Part B, skull base. Volume 73, number 6, December 2012, ISSN 2193-6331 , pp. 365-370, doi : 10.1055 / s-0032-1324397 , PMID 24294552 , PMC 3578588 (free full text) (review)