Zou Jing, Li Hongbin
Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Eur Arch Otorhinolaryngol. 2025 Sep 16. doi: 10.1007/s00405-025-09607-2.
To evaluate the utility of a novel window-damping test (WDT), which involves a simple intratympanic injection of fibrin to dampen the movement of the round window membrane and stapedial footplate, in predicting surgical outcomes for round window reinforcement (RWR) in patients with superior semicircular canal dehiscence syndrome (SSCDS).
This retrospective cohort study included 8 patients with clinically suspected SSCDS. Patients underwent pure-tone audiometry, tympanometry, vestibular-evoked myogenic potential (VEMP) testing, and high-resolution CT scans with multiplanar reconstruction. The WDT involved sequential intratympanic injection of fibrin sealant components into the posterior middle ear cavity to simulate RWR, which was achieved by damping the movement of the round window membrane and stapedial footplate. RWR surgery was performed to alleviate symptoms, and symptom changes were compared between WDT and RWR.
Although signs of a 'third mobile window' were not universally observed in diagnostic tests, WDT yielded positive results in all patients. The test effectively simulated the biomechanical effects of RWR, demonstrating even greater efficacy than surgery in most cases.
The novel WDT is a safe, cost-effective, and valuable preoperative tool for predicting surgical outcomes of RWR in SSCDS.
评估一种新型的窗阻尼试验（WDT）的效用，该试验包括在鼓膜内简单注射纤维蛋白以抑制圆窗膜和镫骨足板的运动，用于预测上半规管裂综合征（SSCDS）患者圆窗强化（RWR）手术的结果。
这项回顾性队列研究纳入了8例临床疑似SSCDS的患者。患者接受了纯音听力测定、鼓室导抗图、前庭诱发肌源性电位（VEMP）测试以及具有多平面重建的高分辨率CT扫描。WDT包括将纤维蛋白密封剂成分序贯注射到中耳后腔以模拟RWR，这是通过抑制圆窗膜和镫骨足板的运动来实现的。进行RWR手术以缓解症状，并比较WDT和RWR之间的症状变化。
尽管在诊断测试中并非普遍观察到“第三活动窗”的迹象，但WDT在所有患者中均产生了阳性结果。该测试有效地模拟了RWR的生物力学效应，在大多数情况下显示出比手术更高的疗效。
新型WDT是一种安全、经济有效且有价值的术前工具，可用于预测SSCDS患者RWR手术的结果。
