Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Otol Neurotol. 2019 Oct;40(9):e925-e927. doi: 10.1097/MAO.0000000000002372.
To discuss an effect of transmastoid repair of superior semicircular canal dehiscence and its resolution using a mastoid titanium mesh plate.
A 53-year-old woman with a history of superior canal dehiscence syndrome (SCDS) and subsequent transmastoid repair experienced dizziness and a loud, drum-like sound in her repaired ear when touching the ear. Palpating the skin over the mastoid defect reproduced the symptoms and could be observed on binocular microscopy as tympanic membrane deformation synchronous with mastoid palpation.
INTERVENTION (S): Surgery to place a titanium mesh cranioplasty plate over the mastoid cavity.
MAIN OUTCOME MEASURE (S): Reduction in dizziness and auditory symptoms when palpating the mastoid.
In follow-up 2 months after surgery, palpation of the left mastoid no longer results in vertigo or hearing a loud sound. Hearing and vestibular function remained unchanged.
Despite resolution of SCDS symptoms after transmastoid plugging and resurfacing of the superior semicircular canal involving mastoidectomy, patients can be bothered by dizziness and vertigo when pressing on the mastoid soft tissue envelope. This acts like a balloon that, when compressed, changes middle ear pressure and moves the tympanic membrane and can even cause alternobaric vertigo. This can be avoided or resolved by rigidly reconstructing the defect in the mastoid bone.
讨论经乳突修复上半规管裂并使用乳突钛网板解决该问题的效果。
一位 53 岁女性，有上半规管裂综合征（SCDS）病史和随后的经乳突修复史，在触摸修复耳时出现头晕和响亮的鼓音。触诊乳突缺损处的皮肤可重现症状，并可在双目显微镜下观察到与乳突触诊同步的鼓膜变形。
干预措施（S）：在乳突腔上放置钛网颅骨成形板的手术。
主要观察指标（S）：触诊乳突时头晕和听觉症状的减轻。
手术后 2 个月随访时，左侧乳突触诊不再引起眩晕或听到响亮声音。听力和前庭功能保持不变。
尽管经乳突填塞和上半规管表面覆盖涉及乳突切除术的 SCDS 症状得到缓解，但当按压乳突软组织包膜时，患者仍可能感到头晕和眩晕。这就像一个气球，当被压缩时，它会改变中耳压力并移动鼓膜，甚至会引起变压性眩晕。通过刚性重建乳突骨中的缺陷可以避免或解决这个问题。
