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Otology/Neurotology

Traumatic Events Preceding the Development of Superior Canal Dehiscence Syndrome

Monday, October 2, 2023
3:51 PM - 3:57 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • EF

    Eric Formeister, MD, MS

    Assistant Professor
    Duke University School of Medicine
    Durham, NC, USA

    • Co-Author(s)

  • PK

    Pavan S. Krishnan, MD

    PGY-1, Department of Otolaryngology-Head & Neck Surgery
    University of Miami/Jackson Health System
    Miami, FL, United States

  • DS

    Desi P. Schoo, MD

    Assistant Professor
    The Ohio State University
    Columbus, OH, United States

  • NA

    Nicholas S. Andresen, MD

    Resident Physician
    Johns Hopkins University School of Medicine
    Baltimore, MD, United States

  • ZS

    Zahra N. Sayyid, MD, PhD

    Johns Hopkins University School of Medicine, USA

  • OW

    Oren Wei, BS

    Medical Student
    Johns Hopkins University School of Medicine
    Baltimore, MD, United States

    • Senior Author(s)

  • John P. Carey, MD

    Professor
    Department of Otolaryngology – Head & Neck Surgery, Johns Hopkins
    Baltimore, MD, United States

Introduction: Most posit that congenital thinning of the otic capsule bone overlying the superior semicircular canal is a necessary but not sufficient condition for the development of superior canal dehiscence syndrome (SCDS). Over two decades of experience at our institution have revealed that many individuals with this disorder endorse preceding head trauma, but no large-scale studies investigating this question have been undertaken. Thus, we sought to describe the features of antecedent head trauma in patients with SCDS.

Methods: An online cross-sectional survey was sent to 134 patients with SCDS who had previously undergone surgical repair at one tertiary medical center. This survey asked specific questions about the characteristics of any internal or external traumatic events preceding symptom development.

Results: One-hundred and thirty-four patients (avg. age, 51.9 years, 62.8% female), completed the survey, of which 59 (44%) described either preceding external head trauma (n=35, 26%), preceding internal pressure event (n=33, 25%), or both (8, 6%). Of those endorsing external trauma, 22 (63%) described a singular event (head hit by object (n=8); head hit ground (n=5); motor vehicle accident (n=4); assault (n=2); other (n=3). One-third experienced loss of consciousness because of the trauma.

For those describing an internal pressure event (n=33), the most common events were heavy physical exertion (9, 27%); elevation changes while flying (6, 18%); coughing/nose blowing with illness (5, 15%); labor during childbirth (5, 15%); and SCUBA events (3, 9%). The interval between trauma and onset of symptoms averaged 5.6 years (S.D., 10.7 years). One-third (n=19) described onset of symptoms immediately after the external trauma or internal pressure event. Symptoms began on the side ipsilateral to the trauma in 91%. Interestingly, sound- and pressure-induced vertigo/oscillopsia developed more commonly after external trauma versus internal pressure events (60% and 51% versus 42% and 30%, respectively).

Conclusions: External trauma or internal pressure related events precede symptoms of SCDS in nearly half of cases.