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Common features in patients with superior canal dehiscence declining surgical treatment.

Benamira LZ, Maniakas A, Alzahrani M, Saliba I - J Clin Med Res (2015)

Bottom Line: The operated group showed more cochlear (6.6 vs. 2.4) symptoms than the non-operated group (P < 0.001) except for hypoacousis, but no significant difference (P = 0.059) was found for the number of vestibular symptoms between both groups (3.4 vs. 1.1).Oscillopsia with effort and with walking was found in 50% and 35.7% of operated patients, respectively, but none in the non-operated group (P < 0.001).The average dehiscence size was 4.7 mm (2.0 - 8.0 mm) and 3.8 mm (1.3 - 7.7 mm) in the operated and non-operated patients, respectively (P = 0.421).

View Article: PubMed Central - PubMed

Affiliation: Montreal University Hospital Center (CHUM), University of Montreal, Montreal, Quebec, Canada.

ABSTRACT

Background: Superior canal dehiscence (SCD) is a benign condition in which a surgical treatment may be considered depending on the patients' tolerance of their symptoms. In this study, we aim to identify driving factors behind the patients' choice of a surgical management over watchful waiting.

Methods: Sixty-two patients with cochlear and/or vestibular symptoms and a temporal bone high-resolution CT (HRCT) scan showing SCD were included in the study. All patients have been offered either surgical management or watchful waiting.

Results: Of these, 28 elected surgery and 34 declined it. The operated group showed more cochlear (6.6 vs. 2.4) symptoms than the non-operated group (P < 0.001) except for hypoacousis, but no significant difference (P = 0.059) was found for the number of vestibular symptoms between both groups (3.4 vs. 1.1). Footstep and eating hyperacousis were both present in 57.1% of operated vs. 3% of non-operated patients (P < 0.001). Oscillopsia with effort and with walking was found in 50% and 35.7% of operated patients, respectively, but none in the non-operated group (P < 0.001). Hearing tuning fork at malleolus and Valsalva and pneumatic speculum induced vertigo showed a statistically significant difference between the two groups (P = 0.003, P < 0.001, P = 0.010 respectively). Cervical vestibular-evoked myogenic potential (cVEMP) thresholds, air and bone conduction thresholds, and mean air-bone gap (ABG) were similar in the two populations (P > 0.05). The average dehiscence size was 4.7 mm (2.0 - 8.0 mm) and 3.8 mm (1.3 - 7.7 mm) in the operated and non-operated patients, respectively (P = 0.421).

Conclusions: The natures of cochleovestibular signs and symptoms were shown to be key factors in patients' choice of a surgical management whereas paraclinical tests seem to be less significant in the patients' decision for a surgical treatment.

No MeSH data available.


Related in: MedlinePlus

Mean air and bone conduction thresholds of operated patients before surgery.
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Figure 1: Mean air and bone conduction thresholds of operated patients before surgery.

Mentions: We compared air and bone conduction thresholds between the two groups at 250, 500, 1,000, 2,000 and 3,000 Hz (Fig. 1, 2). Results showed no statistically significant difference regardless of the tested frequency (P > 0.05). Likewise, ABG at every frequency showed no significant difference between the two groups (P250 Hz = 1.000, P500 Hz = 0.387, P1,000 Hz = 0.684, P2,000 Hz = 1.000 and P3,000 Hz = 1.000).


Common features in patients with superior canal dehiscence declining surgical treatment.

Benamira LZ, Maniakas A, Alzahrani M, Saliba I - J Clin Med Res (2015)

Mean air and bone conduction thresholds of operated patients before surgery.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356090&req=5

Figure 1: Mean air and bone conduction thresholds of operated patients before surgery.
Mentions: We compared air and bone conduction thresholds between the two groups at 250, 500, 1,000, 2,000 and 3,000 Hz (Fig. 1, 2). Results showed no statistically significant difference regardless of the tested frequency (P > 0.05). Likewise, ABG at every frequency showed no significant difference between the two groups (P250 Hz = 1.000, P500 Hz = 0.387, P1,000 Hz = 0.684, P2,000 Hz = 1.000 and P3,000 Hz = 1.000).

Bottom Line: The operated group showed more cochlear (6.6 vs. 2.4) symptoms than the non-operated group (P < 0.001) except for hypoacousis, but no significant difference (P = 0.059) was found for the number of vestibular symptoms between both groups (3.4 vs. 1.1).Oscillopsia with effort and with walking was found in 50% and 35.7% of operated patients, respectively, but none in the non-operated group (P < 0.001).The average dehiscence size was 4.7 mm (2.0 - 8.0 mm) and 3.8 mm (1.3 - 7.7 mm) in the operated and non-operated patients, respectively (P = 0.421).

View Article: PubMed Central - PubMed

Affiliation: Montreal University Hospital Center (CHUM), University of Montreal, Montreal, Quebec, Canada.

ABSTRACT

Background: Superior canal dehiscence (SCD) is a benign condition in which a surgical treatment may be considered depending on the patients' tolerance of their symptoms. In this study, we aim to identify driving factors behind the patients' choice of a surgical management over watchful waiting.

Methods: Sixty-two patients with cochlear and/or vestibular symptoms and a temporal bone high-resolution CT (HRCT) scan showing SCD were included in the study. All patients have been offered either surgical management or watchful waiting.

Results: Of these, 28 elected surgery and 34 declined it. The operated group showed more cochlear (6.6 vs. 2.4) symptoms than the non-operated group (P < 0.001) except for hypoacousis, but no significant difference (P = 0.059) was found for the number of vestibular symptoms between both groups (3.4 vs. 1.1). Footstep and eating hyperacousis were both present in 57.1% of operated vs. 3% of non-operated patients (P < 0.001). Oscillopsia with effort and with walking was found in 50% and 35.7% of operated patients, respectively, but none in the non-operated group (P < 0.001). Hearing tuning fork at malleolus and Valsalva and pneumatic speculum induced vertigo showed a statistically significant difference between the two groups (P = 0.003, P < 0.001, P = 0.010 respectively). Cervical vestibular-evoked myogenic potential (cVEMP) thresholds, air and bone conduction thresholds, and mean air-bone gap (ABG) were similar in the two populations (P > 0.05). The average dehiscence size was 4.7 mm (2.0 - 8.0 mm) and 3.8 mm (1.3 - 7.7 mm) in the operated and non-operated patients, respectively (P = 0.421).

Conclusions: The natures of cochleovestibular signs and symptoms were shown to be key factors in patients' choice of a surgical management whereas paraclinical tests seem to be less significant in the patients' decision for a surgical treatment.

No MeSH data available.


Related in: MedlinePlus