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Occlusion of the round window: a novel way to treat hyperacusis symptoms in superior semicircular canal dehiscence syndrome

Published online by Cambridge University Press:  04 June 2013

A Nikkar-Esfahani ,
D Whelan  and
A Banerjee
A Nikkar-Esfahani
Affiliation:
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK
D Whelan
Affiliation:
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK
A Banerjee*
Affiliation:
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK
*
Address for correspondence: Mr Anirvan Banerjee, Department of Otolaryngology, James Cook University Hospital, Middlesbrough TS4 3RW, UK E-mail: anirvan.banerjee@stees.nhs.uk
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Abstract

Background:

Conductive hyperacusis in superior semicircular canal dehiscence syndrome occurs due to the presence of a ‘third window’ created by the dehiscence. Reversible blocking of the round window can, in theory, cause a reduction in the compression-related volume displacement, and thereby minimise symptoms of conductive hyperacusis. This study describes a technique of permeatal blocking of the round window.

Method:

The tympanomeatal flap is elevated and the round window niche is identified. The round window membrane is subsequently identified and occluded with bone wax, muscle and fascia, in three separate layers. Finally, the tympanomeatal flap is reflected, and an ear wick is inserted.

Results:

Two patients who underwent the procedure reported a reduction in symptoms. Importantly, no Tullio phenomenon was reported post-operation.

Conclusion:

Blocking of the round window can be used to control symptoms of superior semicircular canal dehiscence syndrome in patients who present solely with symptoms of conductive hyperacusis. This technique provides an alternative to resurfacing techniques. The procedure is simple to perform, reversible and can be undertaken as day-case surgery.

Keywords

Semicircular CanalsPathologyRound WindowEarOtologic Surgical Procedures
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 7 , July 2013 , pp. 705 - 707
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented orally at the 2011 American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting and OTO Expo, 11–14 September 2011, San Francisco, California, USA.

References

1Rosowski, JJ, Songer, JE, Nakajima, HH, Brinsko, KM, Merchant, SN. Clinical, experimental, and theoretical investigations of the effect of superior semicircular canal dehiscence on hearing mechanisms. Otol Neurotol 2004;25:323–32CrossRefGoogle ScholarPubMed
2Hirvonen, TP, Carey, JP, Liang, CJ, Minor, LB. Superior canal dehiscence: mechanisms of pressure sensitivity in a chinchilla model. Arch Otolaryngol Head Neck Surg 2001;127:1331–6CrossRefGoogle Scholar
3Minor, LB, Carey, JP, Cremer, PD, Lustig, LR, Streubel, SO, Ruckenstein, J. Dehiscence of bone overlying the superior canal as a cause of apparent conductive hearing loss. Otol Neurotol 2003;22:270–8CrossRefGoogle Scholar
4Beiden, CJ, Weg, N, Minor, LB, Zinreich, SJ. CT evaluation of bone dehiscence of the superior semicircular canal as a cause of sound- and/or pressure-induced vertigo. Radiology 2003;24:270–8Google Scholar
5Watson, SRD, Halmagyi, GM, Coltebach, JG. Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment. Neurology 2000;54:722–8CrossRefGoogle ScholarPubMed
6Carey, J, Minor, LB, Nager, GT. Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg 2000;126:137–47CrossRefGoogle ScholarPubMed
7Banerjee, A, Whyte, A, Atlas, MD. Superior canal dehiscence: review of a new condition. Clin Otolaryngol 2005;30:9–15CrossRefGoogle ScholarPubMed