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Vol. 67, No. 4, 2005
Issue release date: 2005

Management of Superior Canal Dehiscence Syndrome with Extensive Skull-Base Deficiency

Pletcher S.D. · Oghalai J.S. · Reeck J.B. · Cheung S.W.
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Abstract

Superior canal dehiscence syndrome is a recently described condition resulting in noise- or pressure-induced vertigo. We review the case of a 50-year-old woman who presented with debilitating pressure and noise-induced vertigo as well as a low-frequency conductive hearing loss. Imaging was consistent with superior semicircular canal dehiscence syndrome. An extradural middle fossa approach was used to approach the dehiscent superior canal. Intraoperatively, our patient was found to have extensive idiopathic skull base dehiscence of the temporal floor. Middle ear and mastoid mucosa was exposed with focal areas of dura prolapsed into the mastoid cavity. Because of these findings, temporalis fascia and bone pate were used to cover the dehiscent canal as well as a large area of the temporal floor. Additionally, a temporalis muscle flap was rotated between the dura and the dehiscent temporal floor to reconstruct the middle fossa skull base and prevent encephalocele.



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References

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  3. Carey JP, Minor LB, Nager GT: Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg 2000;126:137–147.
  4. Hirvonen TP, Weg N, Zinreich SJ, Minor LB: High-resolution CT findings suggest a developmental abnormality underlying superior canal dehiscence syndrome. Acta Otolaryngol 2003;123:477–481.
  5. Minor LB: Superior canal dehiscence syndrome. Am J Otol 2000;21:9–19.
  6. Brantberg K, Bergenius J, Mendel L, Witt H, Tribukait A, Ygge J: Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 2001;121:68–75.
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