Stenting the Superior Petrosal Sinus in a Patient With Symptomatic Superior Semicircular Canal Dehiscence

Overview

Journal Front Neurol

Specialty Neurology

Date 2018 Sep 5

PMID 30177909

Citations 5

Authors

Eugen C Ionescu

Aurelie Coudert

Pierre Reynard

Eric Truy

Hung Thai-Van

Aicha Ltaief-Boudrigua

Francis Turjman

Affiliations

Soon will be listed here.

Abstract

Patients presenting superior semicircular canal dehiscence (SSCD) can experience symptoms such as conductive hearing loss, pulsatile tinnitus, autophony, and pressure-induced vertigo. Decreased cervical vestibular-evoked myogenic potentials (cVEMPs) thresholds and high-resolution computed tomography (HRCT) of the petrous bone are essential for diagnosis of SSCD syndrome. We report the case of a 43-year-old man suffering from constant right pulsatile tinnitus, intermittent autophony, and unsteadiness induced by physical exercise. An SSCD by the superior petrosal sinus (SPS) was confirmed on the right side by axial HRCT of the temporal bone reformatted in the plane of Pöschl and ipsilateral abnormally low elicited cVEMPs. Treatment options were discussed with the patient since the pulsatile tinnitus progressively became debilitating. Two options were considered: surgery or a new endovascular treatment; the patient chose the latter option. After stenting the right SPS, the intensity of the pulsatile tinnitus dramatically decreased. As there was no complication the patient was discharged at Day 1. The other symptoms improved progressively. By the 60-day follow-up visit the patient only reported a slight tinnitus worsened by physical exercise. Angiographic follow-up at 5 months confirmed the patency of the SPS. Stenting the SPS in patients with SSCD by the SPS appears to be an alternative to the existing surgical treatments.

Citing Articles

Superior semicircular canal dehiscence in relation with the superior petrosal sinus: our experience, surgical management and systematic review of literature.

Rueda Vega M, Lopez Granados C, Aristegui Torrano I, Martin Sanz E, Aristegui Ruiz M Eur Arch Otorhinolaryngol. 2024; 281(9):4665-4675.

PMID: 38698161 DOI: 10.1007/s00405-024-08682-1.

Why should multiple dehiscences of the otic capsule be considered before surgically treating patients with superior semicircular canal dehiscence? A radiological monocentric review and a case series.

Ionescu E, Reynard P, Damien M, Ltaief-Boudrigua A, Hermann R, Gianoli G Front Neurol. 2023; 14:1209567.

PMID: 37614976 PMC: 10442812. DOI: 10.3389/fneur.2023.1209567.

Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities.

Reynard P, Idriss S, Ltaief-Boudrigua A, Bertholon P, Pirvan A, Truy E Front Neurol. 2022; 12:792545.

PMID: 35087471 PMC: 8786803. DOI: 10.3389/fneur.2021.792545.

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops.

Naganawa S, Ito R, Kawai H, Kawamura M, Taoka T, Yoshida T Magn Reson Med Sci. 2021; 21(3):459-467.

PMID: 33896893 PMC: 9316140. DOI: 10.2463/mrms.mp.2021-0010.

Superior Semicircular Canal Dehiscence by Superior Petrosal Sinus: Proposal for Classification.

Ionescu E, Reynard P, Coudert A, Roiban L, Boudrigua A, Thai-Van H J Int Adv Otol. 2021; 17(1):35-41.

PMID: 33605219 PMC: 7901425. DOI: 10.5152/iao.2020.9384.

References

Dubrulle F, Kohler R, Vincent C, Casselman J . [Two particular cases of superior semicircular canal dehiscence related to a procidence of the superior petrous sinus]. J Neuroradiol. 2009; 36(4):240-3. DOI: 10.1016/j.neurad.2009.02.002. View

Minor L, Solomon D, Zinreich J, Zee D . Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg. 1998; 124(3):249-58. DOI: 10.1001/archotol.124.3.249. View

Naert L, van de Berg R, Van de Heyning P, Bisdorff A, Sharon J, Ward B . Aggregating the symptoms of superior semicircular canal dehiscence syndrome. Laryngoscope. 2017; 128(8):1932-1938. DOI: 10.1002/lary.27062. View

Liu Z, Bi W, Li J, Li Q, Dong C, Zhao P . Superior semicircular canal dehiscence in relation to the superior petrosal sinus: a potential cause of pulsatile tinnitus. Clin Radiol. 2015; 70(9):943-7. DOI: 10.1016/j.crad.2015.04.017. View

McCall A, McKenna M, Merchant S, Curtin H, Lee D . Superior canal dehiscence syndrome associated with the superior petrosal sinus in pediatric and adult patients. Otol Neurotol. 2011; 32(8):1312-9. DOI: 10.1097/MAO.0b013e31822e5b0a. View

Belden C, Weg N, Minor L, Zinreich S . CT evaluation of bone dehiscence of the superior semicircular canal as a cause of sound- and/or pressure-induced vertigo. Radiology. 2003; 226(2):337-43. DOI: 10.1148/radiol.2262010897. View

Fetoni A, Lucidi D, De Corso E, Fiorita A, Conti G, Paludetti G . Relationship between Subjective Tinnitus Perception and Psychiatric Discomfort. Int Tinnitus J. 2017; 20(2):76-82. DOI: 10.5935/0946-5448.20160015. View

Schneiders S, Rainsbury J, Hensen E, Irving R . Superior petrosal sinus causing superior canal dehiscence syndrome. J Laryngol Otol. 2017; 131(7):593-597. DOI: 10.1017/S0022215117001013. View

Xie Y, Sharon J, Pross S, Abt N, Varma S, Della Santina C . Surgical Complications from Superior Canal Dehiscence Syndrome Repair: Two Decades of Experience. Otolaryngol Head Neck Surg. 2017; 157(2):273-280. DOI: 10.1177/0194599817706491. View

10.

Ward B, Agrawal Y, Nguyen E, Della Santina C, Limb C, Francis H . Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. Otol Neurotol. 2012; 33(8):1386-91. PMC: 3442142. DOI: 10.1097/MAO.0b013e318268d20d. View

11.

Beyea J, Agrawal S, Parnes L . Transmastoid semicircular canal occlusion: a safe and highly effective treatment for benign paroxysmal positional vertigo and superior canal dehiscence. Laryngoscope. 2012; 122(8):1862-6. DOI: 10.1002/lary.23390. View

12.

Zuniga M, Janky K, Nguyen K, Welgampola M, Carey J . Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol. 2012; 34(1):121-6. PMC: 3521086. DOI: 10.1097/MAO.0b013e31827136b0. View

13.

Trevis K, McLachlan N, Wilson S . A systematic review and meta-analysis of psychological functioning in chronic tinnitus. Clin Psychol Rev. 2018; 60:62-86. DOI: 10.1016/j.cpr.2017.12.006. View

14.

Merchant S, Rosowski J . Conductive hearing loss caused by third-window lesions of the inner ear. Otol Neurotol. 2008; 29(3):282-9. PMC: 2577191. DOI: 10.1097/mao.0b013e318161ab24. View

15.

Carey J, Minor L, Nager G . Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg. 2000; 126(2):137-47. DOI: 10.1001/archotol.126.2.137. View

16.

Jung D, Lookabaugh S, Owoc M, McKenna M, Lee D . Dizziness is more prevalent than autophony among patients who have undergone repair of superior canal dehiscence. Otol Neurotol. 2014; 36(1):126-32. DOI: 10.1097/MAO.0000000000000531. View

17.

Koo J, Hong S, Kim D, Kim J . Superior semicircular canal dehiscence syndrome by the superior petrosal sinus. J Neurol Neurosurg Psychiatry. 2010; 81(4):465-7. DOI: 10.1136/jnnp.2008.155564. View

18.

Cheng Y, Kozin E, Remenschneider A, Nakajima H, Lee D . Characteristics of Wax Occlusion in the Surgical Repair of Superior Canal Dehiscence in Human Temporal Bone Specimens. Otol Neurotol. 2015; 37(1):83-8. PMC: 4674834. DOI: 10.1097/MAO.0000000000000916. View

19.

Newman C, Sandridge S, Jacobson G . Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol. 1998; 9(2):153-60. View

20.

Ziylan F, Kinaci A, Beynon A, Kunst H . A Comparison of Surgical Treatments for Superior Semicircular Canal Dehiscence: A Systematic Review. Otol Neurotol. 2016; 38(1):1-10. DOI: 10.1097/MAO.0000000000001277. View