Superior Canal Dehiscence Syndrome: Symptoms, Causes, Treatment

What are the symptoms of superior canal dehiscence syndrome?

Superior canal dehiscence syndrome (SCDS) is a condition where there is a thinning or absence of the bony covering over the superior semicircular canal of the inner ear. This can lead to a range of symptoms, including:

• Vertigo: A sensation of spinning or dizziness, especially triggered by loud noises or physical activities.
• Hearing Loss: Unilateral or bilateral hearing loss, which can be conductive in nature, meaning it affects the transmission of sound rather than the inner ear’s ability to process it.
• Tinnitus: Ringing, buzzing, or other sounds in the ear that are not caused by external sounds.
• Autophony: An increased perception of one’s own voice or bodily sounds, such as the sound of chewing or breathing, which may seem louder than usual.
• Balance Issues: Difficulty with balance or coordination, particularly when exposed to loud noises or sudden head movements.
• Feeling of Fullness: A sensation of fullness or pressure in the ear.
• Oscillopsia: Visual disturbances where objects appear to move or bounce, particularly during head movements.

These symptoms can vary in intensity and may be triggered or exacerbated by specific activities or environmental conditions. Diagnosis typically involves a combination of audiological tests, imaging studies (such as high-resolution CT scans), and vestibular assessments.

What are the causes of superior canal dehiscence syndrome?

Superior canal dehiscence syndrome (SCDS) is primarily caused by a defect or thinning in the bony covering of the superior semicircular canal in the inner ear. The exact reasons for this defect are not always clear, but several factors may contribute:

1. Congenital Factors: SCDS is often present from birth due to developmental anomalies in the bone structure of the inner ear. It may be related to genetic factors or variations in bone growth during development.
2. Bone Remodeling: Conditions that affect bone density and remodeling, such as osteoporosis or other bone disorders, could contribute to the thinning or absence of the bony covering.
3. Trauma: Physical trauma or injury to the head or ear can potentially lead to or exacerbate a pre-existing dehiscence.
4. Chronic Ear Infections: Recurrent ear infections or chronic inflammation could potentially weaken or damage the bony structures of the inner ear.
5. Elevated Intracranial Pressure: Increased pressure within the skull may contribute to the development or worsening of a dehiscence, though this is less well-documented.
6. Abnormal Bone Growth: Conditions that lead to abnormal bone growth or resorption might result in a dehiscence in the bony covering of the superior semicircular canal.

Overall, while congenital factors are the most common cause, other contributing factors might influence the development or progression of superior canal dehiscence syndrome.

What is the treatment for superior canal dehiscence syndrome?

The treatment for superior canal dehiscence syndrome (SCDS) depends on the severity of symptoms and their impact on the patient’s quality of life. Treatment options include:

1. Conservative Management: For mild symptoms, lifestyle modifications can help manage the condition. This may include avoiding triggers such as loud noises or sudden head movements that exacerbate symptoms.
2. Vestibular Rehabilitation Therapy: Specialized physical therapy designed to improve balance and reduce dizziness. This therapy can help patients adapt to the changes in their vestibular system and improve their overall balance and coordination.
3. Hearing Aids: For those with hearing loss, hearing aids may be recommended to amplify sound and improve hearing function.
4. Medication: Medications may be prescribed to manage symptoms such as vertigo or nauseaearing . These might include vestibular suppressants or anti-nausea drugs.
5. Surgical Intervention: In cases where symptoms are severe and significantly affect quality of life, surgical options may be considered. The most common surgical approach involves:

• Canal Plugging: The superior semicircular canal is plugged or sealed to prevent abnormal fluid movement and reduce symptoms.
• Reconstruction: The bony covering of the superior semicircular canal is reconstructed to restore normal function.

1. Monitoring and Follow-Up: Regular follow-up with an otolaryngologist or a specialist in vestibular disorders to monitor the condition and adjust treatment as necessary.

Surgical options are typically considered only after conservative measures have been tried and if symptoms persist or significantly impact daily life. The choice of treatment is individualized based on the patient’s specific symptoms, overall health, and preferences.