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The effect of superior canal dehiscence size and location on audiometric measurements, vestibular-evoked myogenic potentials and video-head impulse testing

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To correlate objective measures of audio-vestibular function with superior canal dehiscence (SCD) size and location in ears with SCD and compare results with literature.

Methods

We retrospectively evaluated 242 patients exhibiting SCD and/or extremely thinned bone overlying superior canals (SC) on CT scans and selected 73 SCD patients (95 ears with SCD). Data concerning audiometry, impedance audiometry, video-head impulse test (vHIT), cervical vestibular-evoked myogenic potentials (cVEMPs) and ocular VEMPs (oVEMPs) to air- (AC) and bone-conducted (BC) stimuli were collected for each pathologic ear and correlated with dehiscence size and location.

Results

AC pure-tone average (PTA) (p = 0.013), low-frequency air–bone gap (ABG) (p  < 0.001), AC cVEMPs amplitude (p = 0.002), BC cVEMPs amplitude (p < 0.001) and both AC and BC oVEMPs amplitude (p < 0.001) positively correlated with increasing SCD size. An inverse relationship between dehiscence length and both AC cVEMPs and oVEMPs thresholds (p < 0.001) and SC vestibulo–ocular reflex (VOR) gain (p < 0.001) was observed. Dehiscences at the arcuate eminence (AE) exhibited lower SC VOR gains compared to SCD along the ampullary arm (p = 0.008) and less impaired BC thresholds than dehiscences at the superior petrosal sinus (p = 0.04).

Conclusion

We confirmed that SCD size affects AC PTA, ABG and both amplitudes and thresholds of cVEMPs and oVEMPs. We also described a tendency for SC function to impair with increasing SCD size and when dehiscence is located at the AE. The latter data may be explained either by a spontaneous canal plugging exerted by middle fossa dura or by a dissipation through the dehiscence of mechanical energy conveyed to the endolymph during high-frequency impulses.

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Acknowledgements

In memory of Prof. Giovanni Carlo Modugno.

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. ENT & Audiology Unit, Department of Diagnostic, Experimal and Specialty Medicine (DIMES), S.Orsola - Malpighi University Hospital, Bologna, Italy

    Andrea Castellucci, Gianluca Piras, Valeria Del Vecchio, Francesco Maria Crocetta, Gian Gaetano Ferri & Cristina Brandolini

  2. ENT Unit, Department of Surgery, Azienda USL - IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy

    Andrea Castellucci, Francesco Maria Crocetta & Angelo Ghidini

  3. Department of Otology and Skull Base Surgery, Casa Di Cura Privata ‘‘Piacenza’’ S.P.A Gruppo Otologico, Piacenza, Rome, Italy

    Gianluca Piras

  4. UOC Audiology & Vestibology, University Hospital Federico II, Naples, Italy

    Valeria Del Vecchio

  5. Radiology Department, S.Orsola - Malpighi University Hospital, Bologna, Italy

    Vincenzo Maiolo

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  1. Andrea Castellucci
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  2. Gianluca Piras
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Contributions

Conceptualization: AC; Methodology: AC, CB, GP, VDV, VM; Formal analysis and investigation: AC, CB, GP, VDV, VM; Writing—original draft preparation: AC, FMC; Writing—review and editing: AC, CB, GGF; Supervision: AG.

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Correspondence to Andrea Castellucci.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethics Committee of our Institution, approval number 145/2019/Oss/AOUBo) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Castellucci, A., Piras, G., Del Vecchio, V. et al. The effect of superior canal dehiscence size and location on audiometric measurements, vestibular-evoked myogenic potentials and video-head impulse testing. Eur Arch Otorhinolaryngol 278, 997–1015 (2021). https://doi.org/10.1007/s00405-020-06169-3

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