Abstract：
OBJECTIVE: Most of Superior Semicircular Canal Dehiscence (SSCD) are located in the apical region of the SSC. However, in a small number of cases, it may be situated in the medial wall, causing the SSC to contact with the superior petrosal sinus (SPS). The aim of this study is to describe four patients with SSCD involving the superior petrosal sinus (SSCD-SPS) and to perform a review of the literature.
METHODS: Observational retrospective study of patients diagnosed of SSCD-SPS in a tertiary referral center. A systematic review was made, identifying 7 articles in the literature. Clinical presentation, complementary test (pure-tone audiometry, PTA; vestibular evoked myogenic potential, VEMP; computed tomography, CT), therapeutic management and outcomes were reported.
RESULTS: Four new cases of SSCD-SPS are reported, in three of them a transmastoid plugging was performed. 54 patients with SSCD-SPS (57 dehiscences) were reported in the literature. The most frequent symptoms were aural pressure (57.41%) and vertigo provoked by pressure/Valsalva (55.55%). Conductive hearing loss was the most common finding in PTA (47.37%). Abnormally low thresholds were observed in 59.46% of reported VEMP. Transmastoid approach was used in ten cases, middle fossa approach in four, round window reinforcement in one, and occlusion of the SPS using coils in two.
CONCLUSIONS: Within SSCD, we have encountered a rare subtype characterized by its medial wall location in close proximity to the SPS. This subgroup needs special consideration as it has shown its own distinct characteristics. Regarding therapeutic management, we advocate a transmastoid approach.
METHODS: Observational retrospective study of patients diagnosed of SSCD-SPS in a tertiary referral center. A systematic review was made, identifying 7 articles in the literature. Clinical presentation, complementary test (pure-tone audiometry, PTA; vestibular evoked myogenic potential, VEMP; computed tomography, CT), therapeutic management and outcomes were reported.
RESULTS: Four new cases of SSCD-SPS are reported, in three of them a transmastoid plugging was performed. 54 patients with SSCD-SPS (57 dehiscences) were reported in the literature. The most frequent symptoms were aural pressure (57.41%) and vertigo provoked by pressure/Valsalva (55.55%). Conductive hearing loss was the most common finding in PTA (47.37%). Abnormally low thresholds were observed in 59.46% of reported VEMP. Transmastoid approach was used in ten cases, middle fossa approach in four, round window reinforcement in one, and occlusion of the SPS using coils in two.
CONCLUSIONS: Within SSCD, we have encountered a rare subtype characterized by its medial wall location in close proximity to the SPS. This subgroup needs special consideration as it has shown its own distinct characteristics. Regarding therapeutic management, we advocate a transmastoid approach.
摘要：
目的：大多数上半规管裂开（SSCD）位于SSC的顶端区域。然而,在少数情况下，它可能位于内侧壁，导致SSC接触上岩窦（SPS）。这项研究的目的是描述四名涉及上岩窦（SSCD-SPS）的SSCD患者，并对文献进行综述。
方法：在三级转诊中心诊断为SSCD-SPS的患者的观察性回顾性研究。进行了系统的审查，确定文献中的7篇文章。临床表现,补充测试(纯音测听法，PTA;前庭诱发肌源性电位,VEMP;计算机断层扫描,CT),报告了治疗管理和结局.
结果：报告了4例新的SSCD-SPS病例，其中三人进行了乳突堵漏。文献报道了54例SSCD-SPS患者（57例开裂）。最常见的症状是听觉压力（57.41％）和压力/Valsalva引起的眩晕（55.55％）。传导性听力损失是PTA中最常见的发现（47.37％）。在报告的VEMP的59.46％中观察到异常低的阈值。经乳突入路10例，在四个中窝中，圆窗加固合二为一，和使用两个线圈的SPS闭塞。
结论：在SSCD中，我们遇到了一种罕见的亚型，其特征是其内壁位置靠近SPS。这个分组需要特别考虑，因为它已经显示出自己独特的特征。关于治疗管理，我们提倡经乳的方法。
方法：在三级转诊中心诊断为SSCD-SPS的患者的观察性回顾性研究。进行了系统的审查，确定文献中的7篇文章。临床表现,补充测试(纯音测听法，PTA;前庭诱发肌源性电位,VEMP;计算机断层扫描,CT),报告了治疗管理和结局.
结果：报告了4例新的SSCD-SPS病例，其中三人进行了乳突堵漏。文献报道了54例SSCD-SPS患者（57例开裂）。最常见的症状是听觉压力（57.41％）和压力/Valsalva引起的眩晕（55.55％）。传导性听力损失是PTA中最常见的发现（47.37％）。在报告的VEMP的59.46％中观察到异常低的阈值。经乳突入路10例，在四个中窝中，圆窗加固合二为一，和使用两个线圈的SPS闭塞。
结论：在SSCD中，我们遇到了一种罕见的亚型，其特征是其内壁位置靠近SPS。这个分组需要特别考虑，因为它已经显示出自己独特的特征。关于治疗管理，我们提倡经乳的方法。
