Management of Superior Canal Dehiscence Syndrome with Extensive Skull-Base Deficiency

Vol. 67, No. 4, 2005

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Management of Superior Canal Dehiscence Syndrome with Extensive Skull-Base Deficiency
Steven D. Pletcher^a, John S. Oghalai^b, Jay B. Reeck^a, Steven W. Cheung^a

^aDepartment of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, Calif., and
^bBobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex., USA

Address of Corresponding Author

ORL 2005;67:192-195 (DOI: 10.1159/000086663)

Key Words

Superior semicircular canal dehiscence syndrome
Vertigo
Encephalocele
Middle fossa craniotomy

Abstract

Superior canal dehiscence syndrome is a recently described condition resulting in noise- or pressure-induced vertigo. We review the case of a 50-year-old woman who presented with debilitating pressure and noise-induced vertigo as well as a low-frequency conductive hearing loss. Imaging was consistent with superior semicircular canal dehiscence syndrome. An extradural middle fossa approach was used to approach the dehiscent superior canal. Intraoperatively, our patient was found to have extensive idiopathic skull base dehiscence of the temporal floor. Middle ear and mastoid mucosa was exposed with focal areas of dura prolapsed into the mastoid cavity. Because of these findings, temporalis fascia and bone pate were used to cover the dehiscent canal as well as a large area of the temporal floor. Additionally, a temporalis muscle flap was rotated between the dura and the dehiscent temporal floor to reconstruct the middle fossa skull base and prevent encephalocele.

Author Contacts

Steven D. Pletcher, MD
Department of Otolaryngology, Head and Neck Surgery
A730 Box 0342, 400 Parnassus Avenue
San Francisco, CA 94143-0342 (USA)
Tel. +1 415 476 4952, Fax +1 415 353 2603, E-Mail spletcher@ohns.ucsf.edu

Article Information

Received: August 27, 2004
Accepted: September 10, 2004
Published online: July 7, 2005
Number of Print Pages : 4
Number of Figures : 3, Number of Tables : 0, Number of References : 8

Medline Abstract (ID 16006790)

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