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Whyte-Orozco J, Cisneros-Gimeno AI, García-Barrios A, Lozano-Langarita ME, Whyte-Orozco A, Rubio-Aranda E. Association of the superior semicircular canal and tegmen tympani dehiscences and its relationship with the pneumatisation of the temporal bone. Eur Arch Otorhinolaryngol 2024; 281:1267-1272. [PMID: 37777625 PMCID: PMC10858096 DOI: 10.1007/s00405-023-08243-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE To analyse the degree of pneumatisation of the temporal bone when there is an association between dehiscence of the superior semicircular canal and dehiscence of the tegmen tympani. MATERIALS AND METHODS We analysed a retrospective CT study of 124 selected cases. A single inclusion criterion was applied: the presence of a dehiscence of the tegmen tympani. On the other hand, the degree of temporal pneumatisation was assessed by axial and coronal planes, and has been divided into the following grades O, I, II and III, according to the status and relationship of the mastoid, the bony labyrinth, the petrous segment of the carotid canal and sigmoid sinus. RESULTS Of the 124 cases studied, 35 (28.2%) presented both dehiscences. In 26 of the 35 (47.3%), grade II pneumatisation, 4 (14,8%), grade I, and 5 (11,9%) grade III was observed, with a statistically significant relationship (p < 0.001). On the other hand, we did not find a significant relationship when relating both dehiscences in any age or sex group. However, when relating the degree of pneumatisation to sex, among those with grade III pneumatisation, the proportion of men (52.4%) was significantly higher than that of women (47.6%) (p = 0.017). CONCLUSION We have detected a statistically significant relationship between the coexistence of grade II pneumatisation and the presence of both dehiscences in the temporal bone.
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Affiliation(s)
- J Whyte-Orozco
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain
| | - A I Cisneros-Gimeno
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain
| | - A García-Barrios
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain.
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain.
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain.
| | - M E Lozano-Langarita
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
| | - A Whyte-Orozco
- Department of Animal Pathology, School of Veterinary, University of Zaragoza, Zaragoza, Spain
| | - E Rubio-Aranda
- Department of Microbiology, Pediatrics, Radiology and Public Health, School of Medicine, University of Zaragoza, Zaragoza, Spain
- Water and Environmental Health /B43_23R, Zaragoza, Spain
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Ionescu EC, Reynard P, Damien M, Ltaief-Boudrigua A, Hermann R, Gianoli GJ, Thai-Van H. 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. Front Neurol 2023; 14:1209567. [PMID: 37614976 PMCID: PMC10442812 DOI: 10.3389/fneur.2023.1209567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/14/2023] [Indexed: 08/25/2023] Open
Abstract
This review aims to draw attention to the multiple ipsilateral otic capsule dehiscences (OCDs), which may cause therapeutic failure in operated patients. A series of six severely disabled patients with symptoms and signs consistent with a superior semicircular canal dehiscence (SSCD) diagnosis, confirmed by a high-resolution CT scan, is presented here. Five of the patients underwent surgery, and in four of the cases, the postoperative results were poor and/or disappointing. The ethical principles underlying modern medicine encourage medical staff to learn from past experience even when the results are modest despite the accuracy of the treatment applied to a patient. Consequently, we reviewed the radiological records of symptomatic and asymptomatic patients diagnosed or referred to our center for confirmation over the past 5 years to determine the incidence of multiple OCD in this population. Multiple localizations of suspected OCD in the ipsilateral ear did not appear to be rare and were found in 29 of 157 patients (18.47%) in our retrospective review using high-resolution thin-sliced CT scans. The decision to perform surgery for a documented symptomatic superior SSCD should be made with caution only after ruling out concomitant lesser-known variants of OCD in the ipsilateral ear.
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Affiliation(s)
- Eugen C. Ionescu
- Department of Audiology and Otoneurological Explorations, Hospices Civils de Lyon, Lyon, France
- Hearing Institute, Research Center of Pasteur Institute, Team Clinical and Translational Exploration of Sensorineural Hearing Loss, Inserm, Paris, France
| | - Pierre Reynard
- Department of Audiology and Otoneurological Explorations, Hospices Civils de Lyon, Lyon, France
- Hearing Institute, Research Center of Pasteur Institute, Team Clinical and Translational Exploration of Sensorineural Hearing Loss, Inserm, Paris, France
- Department of Physiology, Claude Bernard University, Lyon, France
| | - Maxime Damien
- Department of Audiology and Otoneurological Explorations, Hospices Civils de Lyon, Lyon, France
- Hearing Institute, Research Center of Pasteur Institute, Team Clinical and Translational Exploration of Sensorineural Hearing Loss, Inserm, Paris, France
- Department of Physiology, Claude Bernard University, Lyon, France
| | | | - Ruben Hermann
- Department of ENT, Cervico-Facial Surgery and Audiophonology, Hospices Civils de Lyon, Lyon, France
- Lyon Neuroscience Research Center, IMPACT Team, INSERM, Centre National de la Recherche Scientifique (CNRS), Lyon, France
| | | | - Hung Thai-Van
- Department of Audiology and Otoneurological Explorations, Hospices Civils de Lyon, Lyon, France
- Hearing Institute, Research Center of Pasteur Institute, Team Clinical and Translational Exploration of Sensorineural Hearing Loss, Inserm, Paris, France
- Department of Physiology, Claude Bernard University, Lyon, France
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Altamami N, Khoury M, Saliba I. Manual neuronavigation for superior semicircular canal dehiscence surgery. Front Neurol 2023; 14:1105869. [PMID: 37064194 PMCID: PMC10098155 DOI: 10.3389/fneur.2023.1105869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/28/2023] [Indexed: 04/01/2023] Open
Abstract
BackgroundIntraoperative identification of a superior semicircular canal (SSC) dehiscence via the middle cranial fossa approach (MCFA) remains a difficult endeavor without a neuronavigation system. To address these challenges, we propose a technique to localize the SSC dehiscence intraoperatively using certain anatomical landmarks.MethodThree anatomical landmarks should be identified on preoperative radiological images: the distance from the squamous part of the temporal bone to the dehiscent SSC, the lower limit of the craniotomy, and the exact location of the craniotomy in relation to the bony external auditory canal. The use of these landmarks intraoperatively can allow the surgeon to correctly identify the position of the SSC. Two instructional videos explaining this technique are presented.ConclusionThe proposed manual neuronavigation technique seems to be an accurate, safe, and cost-effective alternative technique for use in SSC dehiscence surgery.
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Affiliation(s)
- Nasser Altamami
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC, Canada
- Otology and Neurotology, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada
| | - Michel Khoury
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC, Canada
- Otology and Neurotology, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada
| | - Issam Saliba
- Division of Otorhinolaryngology and Head & Neck Surgery, University of Montreal, Montreal, QC, Canada
- Otology and Neurotology, University of Montreal Hospital Center (CHUM), Montreal, QC, Canada
- *Correspondence: Issam Saliba
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Dlugaiczyk J. Rare Disorders of the Vestibular Labyrinth: of Zebras, Chameleons and Wolves in Sheep's Clothing. Laryngorhinootologie 2021; 100:S1-S40. [PMID: 34352900 PMCID: PMC8363216 DOI: 10.1055/a-1349-7475] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The differential diagnosis of vertigo syndromes is a challenging issue, as many - and in particular - rare disorders of the vestibular labyrinth can hide behind the very common symptoms of "vertigo" and "dizziness". The following article presents an overview of those rare disorders of the balance organ that are of special interest for the otorhinolaryngologist dealing with vertigo disorders. For a better orientation, these disorders are categorized as acute (AVS), episodic (EVS) and chronic vestibular syndromes (CVS) according to their clinical presentation. The main focus lies on EVS sorted by their duration and the presence/absence of triggering factors (seconds, no triggers: vestibular paroxysmia, Tumarkin attacks; seconds, sound and pressure induced: "third window" syndromes; seconds to minutes, positional: rare variants and differential diagnoses of benign paroxysmal positional vertigo; hours to days, spontaneous: intralabyrinthine schwannomas, endolymphatic sac tumors, autoimmune disorders of the inner ear). Furthermore, rare causes of AVS (inferior vestibular neuritis, otolith organ specific dysfunction, vascular labyrinthine disorders, acute bilateral vestibulopathy) and CVS (chronic bilateral vestibulopathy) are covered. In each case, special emphasis is laid on the decisive diagnostic test for the identification of the rare disease and "red flags" for potentially dangerous disorders (e. g. labyrinthine infarction/hemorrhage). Thus, this chapter may serve as a clinical companion for the otorhinolaryngologist aiding in the efficient diagnosis and treatment of rare disorders of the vestibular labyrinth.
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Affiliation(s)
- Julia Dlugaiczyk
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie
& Interdisziplinäres Zentrum für Schwindel und
neurologische Sehstörungen, Universitätsspital Zürich
(USZ), Universität Zürich (UZH), Zürich,
Schweiz
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