title: The correlation between obesity, obstructive sleep apnea, and superior semicircular canal dehiscence: a new explanation for an increasingly common problem.
abstract: OBJECTIVE
  To investigate rates of obesity and obstructive sleep apnea (OSA) in patients with a diagnosis of superior semicircular canal dehiscence (SSCD).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Two tertiary referral centers.
  
  
  METHODS
  Thirty-one patients with SSCD were identified from patient records at Yale between January 1, 2003 and August 1, 2013 and from the University of Cincinnati between November 1, 2008 and November 1, 2013. The control cohort consisted of 100 consecutive adult patients who obtained high-resolution CT imaging of their temporal bones at Yale University for any reason.
  
  
  METHODS
  CT images were reviewed by two authors in double blind fashion and patient data was analyzed statistically.
  
  
  METHODS
  Rates of OSA, body mass index (BMI), and presence of tegmental defects in patients with SSCD were compared to the control cohort.
  
  
  RESULTS
  The 31 patients with SSCD demonstrated higher BMIs [SSCD avg. 31.62, standard deviation (SD) 8.6 vs. no SSCD 28.01, SD 6.3, P = 0.036], rates of OSA (SSCD 29.03% vs. no SSCD 7.00, P = 0.001), and rates of tegmental defects (SSCD avg. 64.5% vs. no SSCD 16%, P = 1.24 × 10(-7)), in comparison to the control cohort. SSCD was found in 6 of 100 consecutively reviewed adult CT scans and in 0 of 41 scans obtained in those under 17 years of age.
  
  
  CONCLUSIONS
  Patients with SSCD demonstrated higher BMIs, higher rates of OSA, and were more likely to have accompanying tegmental defects. These results may support a possible causality between increased intracranial pressure and the formation of superior semicircular canal dehiscence.
authors.affiliation: *Yale Department of Surgery, Section of Otolaryngology, New Haven, Connecticut, U.S.A.; and †Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Schutt
authors.forename: Paul
authors.initials: P
authors.lastname: Neubauer
authors.forename: Ravi N
authors.initials: RN
authors.lastname: Samy
authors.forename: Myles L
authors.initials: ML
authors.lastname: Pensak
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Kuhn
authors.forename: Meir
authors.initials: M
authors.lastname: Herschovitch
authors.forename: John F
authors.initials: JF
authors.lastname: Kveton
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000000981:diagnostic imaging*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000000981:diagnostic imaging*; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed