Superior semicircular canal dehiscence in East Asian women with osteoporosis
- Alexander YuAffiliated withSouth Cove Community Health CenterDepartment of Neurology, Beth Israel Deaconess Medical Center
- , Douglas L TeichAffiliated withSection of Neuroradiology/Department of Radiology, Beth Israel Deaconess Medical Center
- , Gul MoonisAffiliated withSection of Neuroradiology/Department of Radiology, Beth Israel Deaconess Medical Center
- , Eric T WongAffiliated withSouth Cove Community Health CenterDepartment of Neurology, Beth Israel Deaconess Medical Center Email author
Superior semicircular canal dehiscence (SSCD) may cause Tullio phenomenon (sound-induced vertigo) or Hennebert sign (valsalva-induced vertigo) due to the absence of bone overlying the SSC. We document a case series of elderly East Asian women with atypical SSCD symptoms, radiologically confirmed dehiscence and concurrent osteoporosis.
A retrospective record review was performed on patients with dizziness, vertigo, and/or imbalance from a neurology clinic in a community health center serving the East Asian population in Boston. SSCD was confirmed by multi-detector, high-resolution CT of the temporal bone (with Pöschl and Stenvers reformations) and osteoporosis was documented by bone mineral density (BMD) scans.
Of the 496 patients seen in the neurology clinic of a community health center from 2008 to 2010, 76 (17.3%) had symptoms of dizziness, vertigo, and/or imbalance. Five (6.6%) had confirmed SSCD by multi-detector, high-resolution CT of the temporal bone with longitudinal areas of dehiscence along the long axis of SSC, ranging from 0.4 to 3.0 mm, as seen on the Pöschl view. Two of the 5 patients experienced motion-induced vertigo, two fell due to disequilibrium, and one had chronic dizziness. None had a history of head trauma, otologic surgery, or active intracerebral disease. On neurological examination, two patients had inducible vertigo on Dix-Hallpike maneuver and none experienced cerebellar deficit, Tullio phenomenon, or Hennebert sign. All had documented osteoporosis or osteopenia by BMD scans. Three of them had definite osteoporosis, with T-scores < −2.5 in the axial spine, while another had osteopenia with a T-score of −2.3 in the left femur.
We describe an unusual presentation of SSCD without Tullio phenomenon or Hennebert sign in a population of elderly, East Asian women. There may be an association of SSCD and osteoporosis in this population. Further research is needed to determine the incidence and prevalence of this disorder, as well as the relationship of age, race, osteoporosis risk, and the development of SSCD.
KeywordsVertigo Osteoporosis Superior semicircular canal Canal dehiscence Neurotology
- Superior semicircular canal dehiscence in East Asian women with osteoporosis
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BMC Ear, Nose and Throat Disorders
- Online Date
- July 2012
- Online ISSN
- BioMed Central
- Additional Links
- Superior semicircular canal
- Canal dehiscence
- Author Affiliations
- 1. South Cove Community Health Center, Boston, MA, USA
- 2. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- 3. Section of Neuroradiology/Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA