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22 Symptoms Common to Patients with Superior Canal Dehiscence Syndrome

by ENTtoday •

What are the main evidence-based symptoms reported by patients with superior canal dehiscence syndrome (SCDS) before surgery and without concomitant pathology?

Bottom line
This systematic review identified a 22-item common symptom set that can be used to create an evidence-based patient-reported outcome measure to evaluate health-related quality of life in SCDS.

Background: In SCDS, an absence of bone overlying the superior semicircular canal creates a third mobile window into the inner ear, contributing to a wide variety of auditory and vestibular symptoms, including hearing loss, autophony, pulsatile and nonpulsatile tinnitus, aural fullness, bone conduction hyperacusis, imbalance, vertigo, and oscillopsia. No scale currently exists that captures the broad variety of patient complaints in SCDS.

Study design: Database search of 66 articles describing 431 patients with SCDS performed on May 17, 2017.

Setting: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Clinical Trials Registry, ISI Web of Knowledge and Web of Science.

Synopsis: In total, 91 symptom terms were retrieved from the 1,253 patient symptoms reported. After combining synonymous terms (e.g., aural pressure–aural fullness), 22 specific symptom terms were identified: spontaneous dizziness, sound-induced vertigo, autophony, hearing loss, pressure-induced vertigo, aural pressure, nonpulsatile tinnitus, spontaneous pulsatile tinnitus, hyperacusis to environmental sounds, hyperacusis to bodily sounds, spontaneous oscillopsia/tilting, positional vertigo, motion intolerance, gaze-evoked tinnitus, pulsatile oscillopsia, headache/ear pain, drop attack, sound distortion, head movement–induced pulsatile tinnitus, anxiety, hemifacial numbness, and tinnitus aggravated by Valsalva. Eight of these symptoms were most frequently reported, including spontaneous dizziness, sound-induced vertigo, autophony, hearing loss, pressure-induced vertigo, aural pressure, nonpulsatile tinnitus, and spontaneous pulsatile tinnitus. Limitations included a reliance on accurate assessment and reporting of symptoms by other practitioners, including a possibility that in some articles the physician did not ask about associated diseases. Additionally, vestibular migraine, often seen in patients with SCDS, can present with symptoms of spontaneous dizziness and tinnitus.

Citation: Naert L, Van de Berg R, Van de Heyning P, et al. Aggregating the symptoms of superior semicircular canal dehiscence syndrome [published online ahead of print December 27, 2017]. Laryngoscope. doi: 10.1002/lary.27062.