Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Otolaryngol Head Neck Surg. 2024 Jul;171(1):212-217. doi: 10.1002/ohn.697. Epub 2024 Mar 5.
To describe the features of antecedent head trauma in patients with superior canal dehiscence syndrome (SCDS).
Cross-sectional survey.
Tertiary referral center.
An online survey was sent to 450 adult patients who underwent surgical repair for SCDS patients asking questions about the nature of internal or external traumatic events preceding symptoms.
One-hundred and thirty-six patients (avg. age, 51.9 years, 62.8% female) completed the survey, of which 61 (44.9%) described either preceding external head trauma (n = 35, 26%), preceding internal pressure event (n = 33, 25%), or both (8, 6%). Of those endorsing external trauma, 22 (63%) described a singular event (head hit by object (n = 8); head hit ground (n = 5); motor vehicle accident (n = 4); assault (n = 2); other (n = 3). One-third experienced loss of consciousness because of the trauma. For those describing internal pressure events (n = 33), the most common events were heavy physical exertion (9, 27%); pressure changes while flying (6, 18%); coughing, nose blowing with illness (5, 15%); childbirth (5, 15%); and self contained underwater breathing apparatus diving events (3, 9%). The interval between trauma and onset of symptoms averaged 5.6 years (SD, 10.7 years). One-third (n = 19) described onset of symptoms immediately after the external trauma or internal pressure event. Symptoms began on the side ipsilateral to the trauma in 91%. Sound- and pressure-induced vertigo/oscillopsia developed more commonly after external trauma versus internal pressure events (68% and 61% vs 44% and 32%, respectively).
Trauma or internal pressure-related events precede SCDS symptoms in nearly half of cases, with roughly half of preceding events being external.
描述上半规管裂综合征（SCDS）患者的先前头部创伤特征。
横断面调查。
三级转诊中心。
向 450 名接受过 SCDS 患者手术修复的成年患者发送了一份在线调查，询问他们有关症状出现前内部或外部创伤性事件性质的问题。
136 名患者（平均年龄 51.9 岁，62.8%为女性）完成了调查，其中 61 名（44.9%）描述了先前的外部头部创伤（n=35，26%）、先前的内部压力事件（n=33，25%）或两者兼有（n=8，6%）。在那些有外部创伤的患者中，22 名（63%）描述了单一事件（头部被物体撞击（n=8）；头部撞击地面（n=5）；机动车事故（n=4）；袭击（n=2）；其他（n=3）。三分之一的人因创伤而失去意识。对于那些描述内部压力事件的患者（n=33），最常见的事件是剧烈的体力活动（9 例，27%）；飞行时压力变化（6 例，18%）；咳嗽、生病时擤鼻涕（5 例，15%）；分娩（5 例，15%）；自携式水下呼吸装置潜水事件（3 例，9%）。创伤与症状发作之间的平均间隔为 5.6 年（SD，10.7 年）。三分之一（n=19）描述了外部创伤或内部压力事件后立即出现症状。91%的患者症状始于创伤的同侧。与内部压力事件相比，外部创伤后更常出现声音和压力引起的眩晕/视震颤（68%和 61% vs 44%和 32%）。
创伤或与压力相关的事件在近一半的 SCDS 病例中先于症状出现，其中近一半的先前事件为外部创伤。
