Postpartum Vertigo and Superior Semicircular Canal Dehiscence Syndrome

BACKGROUND: Superior semicircular canal dehiscence is a recently described cause of imbalance, hearing loss, and tinnitus. Symptoms may begin after abrupt changes in intracranial or middle ear pressure. CASE: This patient presented with a 6-year history of imbalance, hearing loss, and pulsatile tinnitus beginning when she was pushing during labor. A temporal-bone computed tomography scan showed a dehiscence of the superior semicircular canal. Surgical repair of the dehiscence through the middle cranial fossa resulted in immediate resolution of the patient's symptoms, and she returned to full activity within 3 weeks. CONCLUSION: Superior semicircular canal dehiscence is recognized increasingly as a cause of multiple otologic symptoms. Obstetricians and gynecologists with patients complaining about postpartum vertigo should inquire about symptom onset and focus their questions around events during the second stage of labor. Patients with symptoms of dehiscence should be referred to a neurootologist for treatment, including possible surgical repair.