Luers J-C, Hüttenbrink K-B
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Köln, 50924, Köln, Deutschland.
HNO. 2013 Sep;61(9):743-9. doi: 10.1007/s00106-013-2747-7.
A dehiscence of the superior semicircular canal is associated with many middle and inner ear symptoms of varying specificity. Concerning the pathophysiology, the way in which these symptoms are connected to a postulated missing bony layer of the superior semicircular canal remains to be completely clarified. In particular, it is unclear why a bony dehiscence might induce symptoms at all; as shown by recent experimental investigations, the natural in vivo coverage of the superior semicircular canal by dura, cerebrospinal fluid and brain prevents changes in inner ear impedance. Diagnosis of superior semicircular canal dehiscence is currently based on a combination of different tests. While cranial computed tomography (with its limited visual resolution) has proven to be largely unsuitable, ocular vestibular-evoked myogenic potentials (oVEMP) are considered an important component of diagnosis. In addition to symptomatic treatment, isolated cases also present the option of highly invasive surgical intervention. Although the majority of published case reports document positive clinical outcomes for operated patients, these procedures are associated with considerable perioperative risks.
上半规管裂与许多特异性各异的中耳和内耳症状相关。关于其病理生理学，这些症状与推测的上半规管骨层缺失之间的联系仍有待完全阐明。尤其不清楚为何骨裂会引发症状；近期实验研究表明，硬脑膜、脑脊液和大脑对上半规管的自然体内覆盖可防止内耳阻抗发生变化。目前，上半规管裂的诊断基于多种检查的综合结果。虽然头颅计算机断层扫描（其视觉分辨率有限）已被证明在很大程度上并不适用，但眼前庭诱发肌源性电位（oVEMP）被视为诊断的重要组成部分。除了对症治疗外，个别病例还可选择高侵入性的手术干预。尽管大多数已发表的病例报告记录了手术患者良好的临床结果，但这些手术伴有相当大的围手术期风险。
