Postoperative Outcomes of Patients with Thin Bone Overlying the Superior Semicircular Canal: A Single Institution's Experience.

Adult Cranial Fossa, Middle / diagnostic imaging Craniotomy / methods Female Humans Male Middle Aged Retrospective Studies Semicircular Canals / diagnostic imaging Temporal Bone / diagnostic imaging Vertigo / etiology
Craniotomy Superior semicircular canal dehiscence Thin bone

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
10 2022
Historique:
received: 19 05 2022
revised: 21 06 2022
accepted: 22 06 2022
pubmed: 3 7 2022
medline: 6 10 2022
entrez: 2 7 2022
Statut: ppublish

Résumé

Superior semicircular canal dehiscence (SSCD) is defined by a bony defect overlying the superior semicircular canal (SSC) in the middle cranial fossa floor, causing a myriad of vestibular and auditory symptoms. Patients with thin bone without full dehiscence overlying the SSC also present with similar symptoms. There are currently no guidelines for surgical management of patients with thin bone. The authors offer their experience with thin bone patients to characterize their symptomatology and explore whether these patients benefit from surgical intervention typically offered to SSCD patients. Two hundred fifty-six patients evaluated for SSCD from 2011 to 2019 were reviewed. High-resolution coronal computed tomography scans with 0.6-mm slice thickness of the temporal bones were assessed to determine whether the patient had a true dehiscence or a thin bone covering overlying the SSC. Bone that was ≤0.5 mm was considered to be "thin bone." Parameters of interest included patient demographics as well as preoperative and postoperative symptomatology. A P value < 0.05 was considered statistically significant. Forty-eight patients met inclusion criteria of having "thin bone." The mean age was 48.13 ± 12.03 years, and 65.5% of patients were female. Of the preoperative symptoms evaluated, the greatest postoperative symptomatic resolution was noted in hearing loss (92.3%), vertigo (94.4%), and oscillopsia (100%). Dizziness (56.5%) had the lowest symptomatic resolution rate. Surgical management of thin bone patients via middle fossa craniotomy, a similar technique to SSCD repair, provides significant symptomatic resolution. Therefore, surgery should be considered in thin bone patients with debilitating symptoms, albeit not having a true dehiscence.

Sections du résumé

BACKGROUND
Superior semicircular canal dehiscence (SSCD) is defined by a bony defect overlying the superior semicircular canal (SSC) in the middle cranial fossa floor, causing a myriad of vestibular and auditory symptoms. Patients with thin bone without full dehiscence overlying the SSC also present with similar symptoms. There are currently no guidelines for surgical management of patients with thin bone. The authors offer their experience with thin bone patients to characterize their symptomatology and explore whether these patients benefit from surgical intervention typically offered to SSCD patients.
METHODS
Two hundred fifty-six patients evaluated for SSCD from 2011 to 2019 were reviewed. High-resolution coronal computed tomography scans with 0.6-mm slice thickness of the temporal bones were assessed to determine whether the patient had a true dehiscence or a thin bone covering overlying the SSC. Bone that was ≤0.5 mm was considered to be "thin bone." Parameters of interest included patient demographics as well as preoperative and postoperative symptomatology. A P value < 0.05 was considered statistically significant.
RESULTS
Forty-eight patients met inclusion criteria of having "thin bone." The mean age was 48.13 ± 12.03 years, and 65.5% of patients were female. Of the preoperative symptoms evaluated, the greatest postoperative symptomatic resolution was noted in hearing loss (92.3%), vertigo (94.4%), and oscillopsia (100%). Dizziness (56.5%) had the lowest symptomatic resolution rate.
CONCLUSIONS
Surgical management of thin bone patients via middle fossa craniotomy, a similar technique to SSCD repair, provides significant symptomatic resolution. Therefore, surgery should be considered in thin bone patients with debilitating symptoms, albeit not having a true dehiscence.

Identifiants

DOI: 10.1016/j.wneu.2022.06.118 PMID: 35779752
pubmed: 35779752
pii: S1878-8750(22)00903-2
doi: 10.1016/j.wneu.2022.06.118
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e93-e98

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Michelle Hong (M)

UCLA Department of Head and Neck Surgery, Los Angeles, California, USA.

Khashayar Mozaffari (K)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Benjamin Uy (B)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Wi Jin Kim (WJ)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Amith Umesh (A)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Anubhav Chandla (A)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Ansley Unterberger (A)

UCLA Department of Neurosurgery, Los Angeles, California, USA.

Isaac Yang (I)

UCLA Department of Head and Neck Surgery, Los Angeles, California, USA; UCLA Department of Neurosurgery, Los Angeles, California, USA; Office of the Patient Experience at UCLA, Los Angeles, California, USA; UCLA Department of Radiation Oncology, Los Angeles, California, USA; UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California, USA; Los Angeles Biomedical Research Institute (LA BioMed) at Harbor-UCLA Medical Center, Torrance, California, USA. Electronic address: iyang@mednet.ucla.edu.

Quinton Gopen (Q)

UCLA Department of Head and Neck Surgery, Los Angeles, California, USA; UCLA Department of Radiation Oncology, Los Angeles, California, USA; UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Appareil locomoteur › Squelette › Crâne › Base du crâne › Fosse crânienne moyenne › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Craniotomie › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Organes des sens › Oreille › Oreille interne › Canaux semicirculaires osseux › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › Appareil locomoteur › Squelette › Crâne › Os temporal › Postoperative Outcomes of Patients with Thin...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Vertige › Postoperative Outcomes of Patients with Thin...