Superior semicircular canal dehiscence presenting as postpartum vertigo.
OBJECTIVE
To describe the clinical and diagnostic features of superior semicircular canal dehiscence (SSCD) in patients with postpartum vertigo.


METHODS
Retrospective review, meta-analysis.


METHODS
Tertiary neurotologic and audiologic center.


METHODS
Two women who presented with a history of acute postpartum vertigo and SSCD confirmed on high-resolution computed tomography (CT) were included. Our meta-analysis of the surgical SSCD literature comprised a total of 43 patients.


METHODS
Patients with postpartum vertigo and SSCD underwent a complete medical evaluation, audiometric testing, CT imaging, magnetic resonance imaging studies, vestibular evoked myogenic potential testing, and laser Doppler vibrometer testing. Case 2 was managed with a middle fossa craniotomy and SSCD repair.


RESULTS
The first patient presented with normal hearing and aural fullness, autophony, and sound sensitivity of the left ear. A 1-mm left-sided SSCD was seen on CT imaging. She is being managed conservatively. The second patient had left-sided conductive hearing loss with sound and pressure sensitivity. The contralateral ear was congenitally deaf. CT imaging revealed a 4-mm left-sided SSCD. Because of her disabling symptoms, the patient underwent a middle fossa craniotomy and superior canal plugging. Her vestibular symptoms resolved with improvement in hearing. Vestibular evoked myogenic potential and laser Doppler vibrometer testing in both cases were consistent with SSCD.


CONCLUSIONS
This is the first description of patients with SSCD presenting after childbirth and should be included in the differential diagnosis of acute postpartum vertigo or disequilibrium. SSCD plugging can provide a stable repair with resolution of symptoms, reversal of diagnostic indicators, and hearing improvement.
Watters
Karen F
KF
Eaton-Peabody Laboratory, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Rosowski
John J
JJ
Sauter
Todd
T
Lee
Daniel J
DJ
D000328:Adult; D001301:Audiometry, Pure-Tone; D003937:Diagnosis, Differential; D005072:Evoked Potentials, Auditory; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D007759:Labyrinth Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D017078:Laser-Doppler Flowmetry; D008279:Magnetic Resonance Imaging; D009622:Noise / Q000009:adverse effects; D049590:Postpartum Period; D011644:Puerperal Disorders / Q000175:diagnosis*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014636:Valsalva Maneuver / Q000502:physiology; D014717:Vertigo / Q000209:etiology*; D014724:Vestibular Function Tests