Trans-mastoid Repair of Superior Semicircular Canal Dehiscence

Objective : Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the superior semicircular canal. Recently, a transmastoid approach for plugging of the superior semicircular canal has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach. Study Design : Retrospective multiinstitutional case series. Material and Methods : Overall 10 patients were included in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, c-VEMP and CT findings. A transmastoid approach was used for plugging of the Sup SC canal. Either a single fenestration was created at the site of dehiscence, or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence. Results : All patients who underwent this procedure had good symptom control and hearing preservation postoperatively. Conclusions : In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach.