Traumatic Events Preceding the Development of Superior Canal Dehiscence Syndrome

Otolaryngol Head Neck Surg. 2024 Mar 5. doi: 10.1002/ohn.697. Online ahead of print.

Abstract

Objective: To describe the features of antecedent head trauma in patients with superior canal dehiscence syndrome (SCDS).

Study design: Cross-sectional survey.

Setting: Tertiary referral center.

Methods: An online survey was sent to 450 adult patients who underwent surgical repair for SCDS patients asking questions about the nature of internal or external traumatic events preceding symptoms.

Results: One-hundred and thirty-six patients (avg. age, 51.9 years, 62.8% female) completed the survey, of which 61 (44.9%) described either preceding external head trauma (n = 35, 26%), preceding internal pressure event (n = 33, 25%), or both (8, 6%). Of those endorsing external trauma, 22 (63%) described a singular event (head hit by object (n = 8); head hit ground (n = 5); motor vehicle accident (n = 4); assault (n = 2); other (n = 3). One-third experienced loss of consciousness because of the trauma. For those describing internal pressure events (n = 33), the most common events were heavy physical exertion (9, 27%); pressure changes while flying (6, 18%); coughing, nose blowing with illness (5, 15%); childbirth (5, 15%); and self contained underwater breathing apparatus diving events (3, 9%). The interval between trauma and onset of symptoms averaged 5.6 years (SD, 10.7 years). One-third (n = 19) described onset of symptoms immediately after the external trauma or internal pressure event. Symptoms began on the side ipsilateral to the trauma in 91%. Sound- and pressure-induced vertigo/oscillopsia developed more commonly after external trauma versus internal pressure events (68% and 61% vs 44% and 32%, respectively).

Conclusion: Trauma or internal pressure-related events precede SCDS symptoms in nearly half of cases, with roughly half of preceding events being external.

Keywords: superior canal dehiscence syndrome; temporal bone; trauma.