Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Suite 562, Los Angeles, CA, 90095-1761, USA.
Radiation Oncology, Los Angeles (UCLA), Los Angeles, CA, USA.
Acta Neurochir (Wien). 2024 May 24;166(1):230. doi: 10.1007/s00701-024-06115-w.
Superior Semicircular Canal Dehiscence (SSCD) is a dehiscence of the otic capsule which normally lies over the superior semicircular canal. This database constitutes the largest series of SSCD patients to date.
To determine what preoperative factors, if any, contribute to postoperative outcomes and evaluate symptom resolution in a large SSCD patient cohort.
A single-institution, retrospective chart review collected patient demographics, intraoperative findings, and pre-and postoperative symptoms. Fisher's exact t-test was performed for unpaired categorical variables, with a significance level of p < 0.05.
350 SSCD repairs were performed. The median age was 52 years (range: 17-86 years, ± 6.4 years), and the median follow-up duration was 4.6 months (range: 0.03-59.5 months, ± 6.8 months). Preoperative hearing loss was significantly associated with female sex (p = 0.0028). The most reported preoperative symptoms were tinnitus (77.4%), dizziness (74.0%), autophony (66.3%), amplification (63.7%), and disequilibrium (62.6%). Between patients who received unilateral versus bilateral SSCD repair, the greatest postoperative symptomatic resolution was seen in autophony (74.9%, p < 0.001), amplification (77.3%, p = 0.00027), hyperacusis (77.4%, p = 0.023), hearing (62.9%, p = 0.0063), and dizziness (54.6%, p < 0.001) for patients with unilateral SSCD repair.
Surgical repair via the middle cranial fossa approach can significantly resolve auditory, vestibular, and neurological symptoms of patients with SSCD. Although this is one of the largest single-institution SSCD studies to date, future multi-institutional, prospective studies would be beneficial to validate these results.
上半规管裂（SSCD）是一种耳囊正常覆盖在上半规管的裂。这个数据库是迄今为止 SSCD 患者最大的系列。
确定任何术前因素，如果有的话，有助于术后结果，并评估大 SSCD 患者队列中的症状缓解。
对一个机构的回顾性图表进行了回顾，收集了患者的人口统计学资料、术中发现以及术前和术后的症状。使用 Fisher 确切检验进行非配对分类变量的分析，显著性水平为 p < 0.05。
共进行了 350 例 SSCD 修复。中位年龄为 52 岁（范围：17-86 岁，± 6.4 岁），中位随访时间为 4.6 个月（范围：0.03-59.5 个月，± 6.8 个月）。术前听力损失与女性性别显著相关（p = 0.0028）。报告最多的术前症状是耳鸣（77.4%）、头晕（74.0%）、自声增强（66.3%）、放大（63.7%）和不平衡（62.6%）。在接受单侧与双侧 SSCD 修复的患者之间，自声增强（74.9%，p < 0.001）、放大（77.3%，p = 0.00027）、听觉过敏（77.4%，p = 0.023）、听力（62.9%，p = 0.0063）和头晕（54.6%，p < 0.001）的最大术后症状缓解见于单侧 SSCD 修复患者。
通过中颅窝入路的手术修复可以显著缓解 SSCD 患者的听觉、前庭和神经症状。尽管这是迄今为止最大的单一机构 SSCD 研究之一，但未来的多机构、前瞻性研究将有助于验证这些结果。
