title: Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence.
abstract: OBJECTIVE
  Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis.
  
  
  BACKGROUND
  The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions).
  
  
  METHODS
  Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations).
  
  
  RESULTS
  Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%.
  
  
  CONCLUSIONS
  This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.
authors: *Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.; ‡Speech and Hearing Bioscience and Technology Program, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, U.S.A.; §Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; ∥Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland; ¶Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center, Utrecht, the Netherlands; and #Department of Otorhinolaryngology - Head and Neck Surgery, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors: Gabrielle R
authors: GR
authors: Merchant
authors: Christof
authors: C
authors: Röösli
authors: Marlien E F
authors: ME
authors: Niesten
authors: Mohamad A
authors: MA
authors: Hamade
authors: Daniel J
authors: DJ
authors: Lee
authors: Melissa L
authors: ML
authors: McKinnon
authors: Cagatay H
authors: CH
authors: Ulku
authors: John J
authors: JJ
authors: Rosowski
authors: Saumil N
authors: SN
authors: Merchant
authors: Hideko Heidi
authors: HH
authors: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003939:Diagnostic Techniques, Otological; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012665:Semicircular Canals / Q000473:pathology*; D014057:Tomography, X-Ray Computed