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Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

Abstract.

The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence.

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References

  1. Minor LB, Solomon D, Zinreich JS, Zee DS (1998) Sound- and/ or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 124:249–258

    CAS  PubMed  Google Scholar 

  2. Hirvonen TP, Carey JP, Liang CJ, Minor LB (2001) Superior canal dehiscence: mechanisms of pressure sensitivity in a chinchilla model. Arch Otolaryngol Head Neck Surg 127:1331–1336

    CAS  PubMed  Google Scholar 

  3. Strupp M, Eggert T, Straube A, Jäger L Querner V, Brandt T (2000) "Inner perilymph fistula" of the anterior semicircular canal. A new disease picture with recurrent attacks of vertigo. Nervenarzt 71:138–142 [in German]

    Article  CAS  PubMed  Google Scholar 

  4. Minor LB (2000) Superior canal dehiscence syndrome. Am J Otol 21:9–19

    CAS  PubMed  Google Scholar 

  5. Brantberg K, Bergenius J, Tribukait A (1999) Vestibular-evoked myogenic potentials in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 119:633–640

    Article  CAS  PubMed  Google Scholar 

  6. Brantberg K, Bergenius J, Mendel L, Witt H, Tribukait A, Ygge J (2001) Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal. Acta Otolaryngol 121:68–75

    Article  CAS  PubMed  Google Scholar 

  7. Watson SR, Halmagyi GM, Colebatch JG (2000) Vestibular hypersensitivity to sound (Tullio phenomenon). Structural and functional assessment. Neurology 54:722–728

    CAS  PubMed  Google Scholar 

  8. Agrawal SK, Parnes LS (2001) Human experience with canal plugging. Ann NY Acad Sci 942:300–305

    CAS  PubMed  Google Scholar 

  9. Lemmerling M, Vanzieleghem B, Dhooge I, Van Cauwenberge P, Kunnen M (2001) CT and MRI of the semicircular canals in the normal and diseased temporal bone. Eur Radiol 11:1210–1219

    Article  CAS  PubMed  Google Scholar 

  10. Tullio P (1929) Das Ohr und die Entstehung von Sprache und Schrift. Urban und Schwarzenberg, Berlin

  11. Fox EJ, Balkany TJ, Arenberg IK (1988) The Tullio phenomenon and perilymph fistula. Arch Otolaryngol Head Neck Surg 98:88–89

    CAS  Google Scholar 

  12. Mong A, Loevner LA, Solomon D, Bigelow DC (1999) Sound- and pressure-induced vertigo associated with dehiscence of the roof of the superior semicircular canal. AJNR 20:1973–1975

    CAS  Google Scholar 

  13. Smullen JL, Andrist EC, Gianoli GJ (1999) Superior semicircular canal dehiscence: a new cause of vertigo. J La State Med Soc 151:397–400

    CAS  PubMed  Google Scholar 

  14. Cawthorne T (1955) Otosclerosis. J Laryngol Otol 69:437–456

    Google Scholar 

  15. Carey JP, Minor LB, Nager GT (2000) Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg 126:137–147

    CAS  PubMed  Google Scholar 

  16. Cremer PD, Minor LB, Carey JP, Della Santina CC (2000) Eye movements in patients with superior canal dehiscence syndrome align with the abnormal canal. Neurology 55:1833–1841

    CAS  PubMed  Google Scholar 

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Correspondence to G. A. Krombach.

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Krombach, G.A., DiMartino, E., Schmitz-Rode, T. et al. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence. Eur Radiol 13, 1444–1450 (2003). https://doi.org/10.1007/s00330-003-1828-5

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  • DOI: https://doi.org/10.1007/s00330-003-1828-5

Keywords

  • Computed tomography
  • Temporal bone
  • Superior semicircular canal dehiscence
  • Posterior semicircular canal dehiscence