![]() However, the diagnostic evaluation of patients with suspected SCDS can sometimes be difficult to interpret. For patients with debilitating symptoms, definitive treatment involves surgical repair of the dehiscence. Indeed, HUV is significantly lower in SCDS patients (0.68) compared to the general U.S. The health utility value (HUV), a measure of general health-related quality of life, ranges from poor health (0.3), to perfect health (1.0). While in most patients symptoms of SCDS can be tolerated and conservative management is reasonable, some individuals suffering from SCDS report decreased quality of life due to challenges in communicating with those around them and completing activities of daily living ( 5– 7). In subsequent years, auditory symptoms, including autophony, amplification of bodily sounds, pulsatile tinnitus, conductive hearing loss, hyperacusis, and aural fullness as well as vestibular symptoms of chronic disequilibrium and sound- and pressure-induced vertigo and oscillopsia became hallmarks of SCDS ( 2– 4). Symptom improvement was observed in patients who underwent surgical plugging of the defect via middle fossa craniotomy. Computed tomography (CT) imaging revealed a bony defect of the SSC. The authors described a series of patients with disequilibrium and sound- and pressure-induced vertigo associated with nystagmus in the plane of the superior semicircular canal (SSC). ![]() Superior semicircular canal dehiscence syndrome (SCDS) was first reported by Minor et al. Herein, we will discuss both contemporary and emerging diagnostic approaches for patients with SCDS and highlight challenges and controversies in the management of this unique patient cohort. Finally, there is no established algorithm in evaluation of SCDS patients who fail primary repair and may be candidates for revision surgery. Third, even when SCD repair is indicated, there is a lack of consensus about nomenclature to describe the SCD, ideal surgical approach, specific repair techniques, and type of materials used. Second, while high-resolution computed tomography (CT) is the gold standard for the detection of SCD, a bony defect does not always result in signs and symptoms. SCDS mimics a number of common otologic disorders and established metrics such as supranormal bone conduction thresholds and vestibular evoked myogenic potential (VEMP) measurements although useful in certain cases, have diagnostic limitations. First, there is currently no standardized clinical testing algorithm for quantifying the effects of superior canal dehiscence (SCD). Over the past two decades, advances in diagnostic techniques have raised the awareness of SCDS and treatment approaches have been refined to improve patient outcomes. Patients with superior canal dehiscence syndrome (SCDS) can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of the superior semicircular canal (SSC).
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