Zhao Yi Chen, Somers Thomas, van Dinther Joost, Vanspauwen Robby, Husseman Jacob, Briggs Robert
Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
J Neurol Surg B Skull Base. 2012 Aug;73(4):225-9. doi: 10.1055/s-0032-1312713.
Objective/Hypothesis Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the Sup SC. Recently, a transmastoid approach for plugging of the Sup SC has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach. Design This is a retrospective multi-institutional case series. Method We included 10 patients in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, vestibular evoked myogenic potential, and computed tomography findings. A transmastoid approach was used for plugging of the Sup SC. Either a single fenestration was created at the site of dehiscence or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence. Results All patients who underwent this procedure had good symptom control and hearing preservation postoperatively. Conclusion In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach.
目的/假设 上半规管（Sup SC）裂综合征是一种罕见疾病，可引起多种听觉和前庭症状。传统的手术治疗方法是采用颅中窝硬膜外入路对上半规管进行重建。最近，已经开发出一种经乳突入路来封堵上半规管。我们提供了进一步的数据，支持优先使用经乳突入路而非中颅窝入路。设计 这是一项回顾性多机构病例系列研究。方法 我们纳入了来自两家三级耳科机构的该病例系列中的10名患者。通过临床症状与听力测定、前庭诱发肌源性电位及计算机断层扫描结果阳性之间的相关性，证实存在上半规管裂。采用经乳突入路封堵上半规管。在裂孔部位创建单个开窗，或在裂孔的壶腹侧和离壶腹侧分别创建开窗。结果 所有接受该手术的患者术后症状控制良好且听力得以保留。结论 对于颞骨气化良好的患者，经乳突入路为颅中窝入路提供了一种安全有效的替代方法。该系列研究表明经乳突入路能实现出色的症状控制和听力保留。
