本文介绍了Bárány学会分类委员会提出的上半规管裂开综合征(SCDS)的诊断标准。除了在高分辨率成像上存在上半规管的裂开之外,被诊断为SCDS的患者的症状和生理检查必须与“第三移动窗口”综合征的病理生理学一致,并且不能更好地解释其他前庭疾病或疾病。因此,SCDS的诊断需要结合以下各项:A)至少一种与SCDS一致的症状,并归因于“第三移动窗口”病理生理学,包括1)骨传导声音过度,2)声音诱发的眩晕和/或示波时间锁定到刺激,3)压力诱发的眩晕和/或示波时间锁定到刺激,或4)搏动性耳鸣;B)至少1次生理测试或体征,表明第三移动窗口正在传递压力,包括1)当向受影响的耳朵施加声音或压力时,在受影响的上半规管平面中的眼球运动,2)纯音测听法的低频负骨传导阈值,或3)增强的前庭诱发肌源性电位(VEMP)反应(宫颈VEMP阈值低或眼部VEMP振幅升高);和C)高分辨率计算机断层扫描(CT)扫描,在上半规管平面内进行多平面重建,与裂开一致。因此,在三个主要诊断类别中至少满足一个标准的患者(症状,生理测试,和成像)被认为有SCDS。
This paper describes the diagnostic criteria for superior semicircular canal dehiscence syndrome (SCDS) as put forth by the classification committee of the Bárány Society. In addition to the presence of a dehiscence of the superior semicircular canal on high resolution imaging, patients diagnosed with SCDS must also have symptoms and physiological tests that are both consistent with the pathophysiology of a \'third mobile window\' syndrome and not better accounted for by another vestibular disease or disorder. The diagnosis of SCDS therefore requires a combination of A) at least one symptom consistent with SCDS and attributable to \'third mobile window\' pathophysiology including 1) hyperacusis to bone conducted sound, 2) sound-induced vertigo and/or oscillopsia time-locked to the stimulus, 3) pressure-induced vertigo and/or oscillopsia time-locked to the stimulus, or 4) pulsatile tinnitus; B) at least 1 physiologic test or sign indicating that a \'third mobile window\' is transmitting pressure including 1) eye movements in the plane of the affected superior semicircular canal when sound or pressure is applied to the affected ear, 2) low-frequency negative bone conduction thresholds on pure tone audiometry, or 3) enhanced vestibular-evoked myogenic potential (VEMP) responses (low cervical VEMP thresholds or elevated ocular VEMP amplitudes); and C) high resolution computed tomography (CT) scan with multiplanar reconstruction in the plane of the superior semicircular canal consistent with a dehiscence. Thus, patients who meet at least one criterion in each of the three major diagnostic categories (symptoms, physiologic tests, and imaging) are considered to have SCDS.