title: Revision Surgery for Superior Canal Dehiscence Syndrome.
abstract: To identify factors associated with surgical failure for superior canal dehiscence syndrome (SCDS) and define rates of complications and cure after revision SCDS repair.
  
  
  
  Retrospective patient series.
  
  
  
  Tertiary care referral center.
  
  
  
  Adults who underwent revision surgery for SCDS.
  
  
  
  None.
  
  
  
  Initial surgical approach, intraoperative findings at the time of revision, persistence of symptoms, and complications for revision surgery.
  
  
  
  Two hundred twenty-two surgical SCDS patients were identified, including 21 subjects who underwent 23 revision surgeries. Fourteen (61%) underwent previous middle fossa and nine (39%) underwent previous transmastoid approaches. Intraoperative findings showed that in 17 (74%) the previous material used to plug or resurface the canal was present but not entirely covering the dehiscence. In one (4%) the material was not present. In one (4%) the material was in proper position, whereas in four (17%) the material was in proper position with very thin bone adjacent. After revision surgery, symptoms were completely resolved in eight (35%), partially resolved in seven (30%), and not resolved in seven (30%). Findings of thin bone adjacent to the previous plug was associated with failure of symptom resolution (p = 0.03). Hearing outcomes were compared to a previously studied cohort of primary surgery patients, and outcomes were similar. Three subjects (13%) had a significant decrease in their word recognition score after revision surgery (p=0.52), and seven (30%) had a significant increase in their pure-tone average (p=0.78).
  
  
  
  Revision surgery for SCDS can be curative in carefully selected patients, but there may be a higher failure rate than primary surgery, with similar hearing outcomes.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Sharon
authors.forename: Seth E
authors.initials: SE
authors.lastname: Pross
authors.forename: Bryan K
authors.initials: BK
authors.lastname: Ward
authors.forename: John P
authors.initials: JP
authors.lastname: Carey
mesh_terms: D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome