Clinical factors associated with prolonged recovery after superior canal dehiscence surgery.
OBJECTIVE
To identify clinical factors associated with prolonged recovery after superior canal dehiscence surgery.


METHODS
Retrospective review.


METHODS
Tertiary care academic medical center.


METHODS
Thirty-three patients that underwent surgery for SCDS were identified from a database of 140 patients diagnosed with SCD (2000-2010) at the Massachusetts Eye and Ear Infirmary (U.S.A.). The diagnosis of SCDS was based on clinical signs and symptoms, audiometric and vestibular testing and high-resolution temporal bone computed tomography.


METHODS
For the primary repair, the superior canal was plugged in 31 patients through a middle fossa craniotomy approach and in 1 patient through a transmastoid approach. In 1 patient, the SCD was resurfaced through a middle fossa craniotomy approach.


METHODS
Postoperative clinical signs and symptoms and factors that may influence duration of disequilibrium after surgery.


RESULTS
Thirty-three patients (15-71 yr; mean, 43 yr) underwent surgery for SCDS on 35 ears (2 bilateral). Mean follow-up was 28.7 months (range, 3 mo to 10 yr); 33 of 33 (100%) patients experienced initial improvement of the chief complaint. Three patients required revision surgery, improving symptoms in 2 patients. Six patients had dizziness lasting more than 4 months postoperatively, and all had bilateral SCD, migraines, and a dehiscence of 3 mm or greater.


CONCLUSIONS
Surgical plugging of SCD is an effective management option to provide long-term improvement of the chief complaint in SCDS patients. Patients with bilateral SCD, a history of migraines, and larger defects may be at risk of prolonged recovery and should be appropriately counseled.
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center, Utrecht, The Netherlands.
Marlien E F
ME
Niesten
Michael J
MJ
McKenna
Wilko
W
Grolman
Daniel J
DJ
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D004244:Dizziness / Q000000981:diagnostic imaging / Q000601:surgery; D004427:Ear Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000000981:diagnostic imaging / Q000601:surgery*; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014717:Vertigo / Q000000981:diagnostic imaging / Q000601:surgery