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Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.

Publication ,  Journal Article
Ward, BK; Agrawal, Y; Nguyen, E; Della Santina, CC; Limb, CJ; Francis, HW; Minor, LB; Carey, JP
Published in: Otol Neurotol
October 2012

OBJECTIVE: To determine postoperative hearing outcomes after surgical plugging via middle cranial fossa approach for superior semicircular canal dehiscence syndrome (SCDS). STUDY DESIGN: Clinical review. SETTING: Tertiary care medical center. PATIENTS: Forty-three cases of SCDS based on history, physical examination, vestibular function testing, and computed tomography imaging confirming the presence of a dehiscence. All patients underwent surgical plugging of the superior semicircular canal via middle cranial fossa approach. INTERVENTION: Pure tone audiometry was performed preoperatively and at 7 days and at least 1 month postoperatively. MAIN OUTCOME MEASURES: Change in air-bone gap (ABG) and pure tone average (PTA). RESULTS: Preoperative average ABG across 0.25, 0.5, 1, and 2 kHz was 16.0 dB (standard deviation [SD], 7.5 dB). At 7 days postoperatively, average ABG was 16.5 dB (SD, 11.1; p = 0.42), and at greater than 1 month was 8.1 dB (SD, 8.4; p < 0.001). 53% (95% confidence interval, 33-69) of affected ears had greater than 10 dB increase in their 4-frequency (0.5, 1, 2, and 4 kHz) PTA measured by bone-conduction (BC) threshold 7 days postoperatively and 25% (95% confidence interval, 8-39) at greater than 1 month postoperatively. Mean BC PTA of affected ears was 8.4 dB hearing loss (HL) (SD, 10.4) preoperatively. Compared with baseline, this declined to 19.2 dB HL (SD, 12.6; p < 0.001) at 7 days postoperatively and 16.4 dB HL (SD, 18.8; p = 0.01) at greater than 1 month. No significant differences in speech discrimination score were noted (F = 0.17). CONCLUSION: Low-frequency air-bone gap decreases after surgical plugging and seems to be due to both increased BC thresholds and decreased AC thresholds. Surgical plugging via a middle cranial fossa approach in SCDS is associated with mild high-frequency sensorineural hearing loss that persists in 25% but no change in speech discrimination.

Duke Scholars

Published In

Otol Neurotol

DOI

EISSN

1537-4505

Publication Date

October 2012

Volume

33

Issue

8

Start / End Page

1386 / 1391

Location

United States

Related Subject Headings

  • Vestibular Function Tests
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Surgical Instruments
  • Surgery, Computer-Assisted
  • Speech Perception
  • Semicircular Canals
  • Otorhinolaryngology
  • Otologic Surgical Procedures
  • Middle Aged
 

Citation

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Ward, B. K., Agrawal, Y., Nguyen, E., Della Santina, C. C., Limb, C. J., Francis, H. W., … Carey, J. P. (2012). Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. Otol Neurotol, 33(8), 1386–1391. https://doi.org/10.1097/MAO.0b013e318268d20d
Ward, Bryan K., Yuri Agrawal, Elena Nguyen, Charles C. Della Santina, Charles J. Limb, Howard W. Francis, Lloyd B. Minor, and John P. Carey. “Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.Otol Neurotol 33, no. 8 (October 2012): 1386–91. https://doi.org/10.1097/MAO.0b013e318268d20d.
Ward BK, Agrawal Y, Nguyen E, Della Santina CC, Limb CJ, Francis HW, et al. Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. Otol Neurotol. 2012 Oct;33(8):1386–91.
Ward, Bryan K., et al. “Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.Otol Neurotol, vol. 33, no. 8, Oct. 2012, pp. 1386–91. Pubmed, doi:10.1097/MAO.0b013e318268d20d.
Ward BK, Agrawal Y, Nguyen E, Della Santina CC, Limb CJ, Francis HW, Minor LB, Carey JP. Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. Otol Neurotol. 2012 Oct;33(8):1386–1391.

Published In

Otol Neurotol

DOI

EISSN

1537-4505

Publication Date

October 2012

Volume

33

Issue

8

Start / End Page

1386 / 1391

Location

United States

Related Subject Headings

  • Vestibular Function Tests
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Surgical Instruments
  • Surgery, Computer-Assisted
  • Speech Perception
  • Semicircular Canals
  • Otorhinolaryngology
  • Otologic Surgical Procedures
  • Middle Aged