An Evidence-Based Approach to the Treatment of Superior Canal Dehiscence Syndrome (2022 AMW)
2022 AAO-HNSF Annual Meeting & OTO Experience
Superior semicircular canal dehiscence syndrome (SCDS) was first reported by Minor et al. in 1998. They described a cohort of patients with disequilibrium and sound- and pressure-induced vertigo associated with nystagmus in the plane of the superior semicircular canal (SSCC) in addition to CT imaging showing a bony defect over the SSCC. Other symptoms including autophony, pulsatile tinnitus, conductive hearing loss, aural fullness, and chronic disequilibrium have since become hallmarks of the syndrome. Diagnosing SCDS can be challenging as symptoms can vary and often mimic other otologic and neurotologic conditions. Additionally, the diagnostic battery can involve many tests with no standardized protocol. While in most patients symptoms of SCDS can be tolerated and conservative management is reasonable, some patients with debilitating symptoms will require definitive treatment. The optimal surgical approach, repair technique, and timing remain the subjects of debate and confusion amongst otolaryngologists and neurotologists alike. This multidisciplinary panel session will focus on the evaluation and management of superior semicircular canal dehiscence syndrome (SCDS) using available data to formulate an evidence-based approach. Discussion will center on diagnostic criteria including patient-related subjective complaints and objective neurophysiologic data, recommendations for and essential findings on imaging, and the multiple treatment options to be considered incorporating both surgical and non-surgical interventions. Specifically, the panel will also address the complicated radiographic anatomy and occasional diagnostic dilemmas associated with computed tomography and magnetic resonance imaging in patients with SCDS. As there exists significant heterogeneity in the evaluation and care of these patients, the panel will also attempt to summarize the data as it relates to predictors of successful outcomes, patient expectations, and differences in surgical approaches.
Credits
CME:1.0, MOC:1.0
Courses in package:
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2022 AAO-HNSF Annual Meeting & OTO Experience
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