Department of Otorhinolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK.
Department of Otorhinolaryngology - Head and Neck Surgery, Hanover Medical School, Hanover, Germany.
J Laryngol Otol. 2022 Apr;136(4):284-292. doi: 10.1017/S0022215121002826. Epub 2021 Oct 7.
Described just over 20 years ago, superior semicircular canal dehiscence remains a relatively unknown and easily missed cause of dizziness and auditory symptoms.
This review focused on the origin, presenting symptoms and underlying pathophysiology of superior semicircular canal dehiscence, and the available treatment options.
The bony dehiscence acts as a 'third window', affecting inner-ear homeostasis, and resulting in hypersensitivity and a vestibular response to lower sound level stimuli. The third window effect explains the pressure- and sound-induced vertigo, oscillopsia, and nystagmus, as well as autophony, conductive hyperacusis and tinnitus. The origin of superior semicircular canal dehiscence is linked to the combination of a congenital or developmental factor, and a 'second event' like head trauma, rapid pressure changes or age-related factors. Computed tomography of the temporal bone and reduced vestibular-evoked myogenic potential thresholds can confirm the diagnosis. Despite only retrospective cohorts, surgery is considered a safe treatment option, targeting mainly vestibular but also auditory symptoms, with transmastoid approaches gaining popularity.
大约 20 年前被描述的上半规管裂，仍然是一种相对未知且容易被忽视的头晕和听觉症状的原因。
本综述重点介绍上半规管裂的起源、临床表现和潜在病理生理学，以及现有的治疗选择。
骨裂作为“第三窗口”，影响内耳的动态平衡，导致对较低声级刺激的敏感性和前庭反应。第三窗口效应解释了压力和声音引起的眩晕、眼球震颤、眼震和耳鸣、传导性听力过敏和耳鸣。上半规管裂的起源与先天性或发育性因素以及头部创伤、压力快速变化或与年龄相关的因素等“第二事件”的组合有关。颞骨的计算机断层扫描和降低的前庭诱发肌源性电位阈值可以确认诊断。尽管只有回顾性队列研究，但手术被认为是一种安全的治疗选择，主要针对前庭症状，也针对听觉症状，经乳突入路越来越受欢迎。
