title: Round window reinforcement for superior semicircular canal dehiscence: a retrospective multi-center case series.
abstract: OBJECTIVE
  To evaluate the outcome of round window (RW) tissue reinforcement in the management of superior semicircular canal dehiscence (SSCD).
  
  
  METHODS
  Twenty-two patients with confirmed diagnosis of SSCD by clinical presentation, imaging, and/or testing were included in the study. Six surgeons at four institutions conducted a multicenter chart review of patients treated for symptomatic superior canal dehiscence using RW tissue reinforcement or complete RW occlusion. A transcanal approach was used to reinforce the RW with various types of tissue. Patients completed a novel postoperative survey, grading preoperative and postoperative symptom severity.
  
  
  RESULTS
  Analysis revealed statistically significant improvement in all symptoms with the exception of hearing loss in 19 patients who underwent RW reinforcement. In contrast, 2 of 3 participants who underwent the alternate treatment of RW niche occlusion experienced worsened symptoms requiring revision surgery.
  
  
  CONCLUSIONS
  RW tissue reinforcement may reduce the symptoms associated with SSCD. The reinforcement technique may benefit SSCD patients by reducing the "third window" effect created by a dehiscent semicircular canal. Given its low risks compared to middle cranial fossa or transmastoid canal occlusion, RW reinforcement may prove to be a suitable initial procedure for intractable SSCD. In contrast, complete RW occlusion is not advised.
authors.affiliation: Silverstein Institute, Ear Research Foundation, Sarasota, FL. Electronic address: hsilverste@aol.com.
authors.forename: Herbert
authors.initials: H
authors.lastname: Silverstein
authors.affiliation: Michigan Ear Institute, Farmington Hills, MI.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Kartush
authors.affiliation: London Health Sciences Centre, London, Ontario.
authors.forename: Lorne S
authors.initials: LS
authors.lastname: Parnes
authors.affiliation: Boston Children's Hospital, Boston, MA.
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Poe
authors.affiliation: Michigan Ear Institute, Farmington Hills, MI.
authors.forename: Seilesh C
authors.initials: SC
authors.lastname: Babu
authors.affiliation: Saratoga Ear and Sinus Surgery, Saratoga Springs, NY.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Levenson
authors.affiliation: Silverstein Institute, Ear Research Foundation, Sarasota, FL.
authors.forename: Jack
authors.initials: J
authors.lastname: Wazen
authors.affiliation: Silverstein Institute, Ear Research Foundation, Sarasota, FL.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: Ridley
mesh_terms: D034381:Hearing Loss / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D013506:Otologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000601:surgery*; D012665:Semicircular Canals / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome