Transmastoid Occlusion Surgery for Superior Semicircular Canal Dehiscence Syndrome Improves Patient-Reported Quality-of-Life Measures and corrects cVEMP Thresholds and Amplitudes
Copyright © 2021, Otology & Neurotology, Inc..
OBJECTIVE: To determine the pre- and postoperative clinical, audiological, vestibular, and patient-reported measures in patients undergoing transmastoid occlusion surgery for superior canal dehiscence syndrome (SCDS).
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral centre, UK.
PATIENTS: All primary transmastoid occlusion surgeries for SCDS were included (tertiary centre, single-surgeon), January 2008 to July 2019.
INTERVENTIONS: Transmastoid superior canal occlusion surgery for SCDS.
MAIN OUTCOME MEASURES: We collated audiological (pure tone audiogram), vestibular (cervical vestibular evoked myogenic potentials [cVEMPs]), and patient-reported outcome measures (Dizziness Handicap Inventory and subjective symptom grading).
RESULTS: Fifty-two patients (55 ears) met the inclusion criteria. Thirty-one (56%) were female. Mean age was 47 years (range 29-63) and mean follow-up of 11.2 months. Six patients had bilateral disease, four of whom underwent sequential, bilateral surgery.Autophony was the most frequent presenting symptom, improving in 92%.Significant improvements were self-reported in patients' autophony (p < 0.0001), pressure- and noise-induced dizziness (p < 0.0001 and p < 0.0001), aural fullness (p = 0.0159), pulsatile tinnitus (p < 0.0001), perceived hearing loss (p = 0.0058), and imbalance (p = 0.0303).Overall Dizziness Handicap Inventory scores reduced from 45.9 to 27.4 (p < 0.0001), and across all subgroups of functional (p = 0.0003), emotional (p < 0.0001), and physical handicap (p = 0.0005).A 6.4-dB HL improvement in the air-bone gap (500-1000 Hz) occurred (95% confidence intervals 3.3-9.4 dB HL, p < 0.0001). There were no dead ears. cVEMP thresholds, when recordable, normalized in all except two ears.
CONCLUSIONS: Transmastoid occlusion is effective at improving patient-reported outcomes and normalizing cVEMP thresholds, though some symptoms, notably disequilibrium, persist to a variable degree.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology - 42(2021), 10 vom: 01. Dez., Seite 1534-1543 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Wolf, Maarten J F [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 09.03.2022 Date Revised 31.05.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/MAO.0000000000003329 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a de Wolf, Maarten J F |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Transmastoid Occlusion Surgery for Superior Semicircular Canal Dehiscence Syndrome Improves Patient-Reported Quality-of-Life Measures and corrects cVEMP Thresholds and Amplitudes |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 09.03.2022 | ||
| 500 | |a Date Revised 31.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021, Otology & Neurotology, Inc. | ||
| 520 | |a OBJECTIVE: To determine the pre- and postoperative clinical, audiological, vestibular, and patient-reported measures in patients undergoing transmastoid occlusion surgery for superior canal dehiscence syndrome (SCDS) | ||
| 520 | |a STUDY DESIGN: Retrospective case review | ||
| 520 | |a SETTING: Tertiary referral centre, UK | ||
| 520 | |a PATIENTS: All primary transmastoid occlusion surgeries for SCDS were included (tertiary centre, single-surgeon), January 2008 to July 2019 | ||
| 520 | |a INTERVENTIONS: Transmastoid superior canal occlusion surgery for SCDS | ||
| 520 | |a MAIN OUTCOME MEASURES: We collated audiological (pure tone audiogram), vestibular (cervical vestibular evoked myogenic potentials [cVEMPs]), and patient-reported outcome measures (Dizziness Handicap Inventory and subjective symptom grading) | ||
| 520 | |a RESULTS: Fifty-two patients (55 ears) met the inclusion criteria. Thirty-one (56%) were female. Mean age was 47 years (range 29-63) and mean follow-up of 11.2 months. Six patients had bilateral disease, four of whom underwent sequential, bilateral surgery.Autophony was the most frequent presenting symptom, improving in 92%.Significant improvements were self-reported in patients' autophony (p < 0.0001), pressure- and noise-induced dizziness (p < 0.0001 and p < 0.0001), aural fullness (p = 0.0159), pulsatile tinnitus (p < 0.0001), perceived hearing loss (p = 0.0058), and imbalance (p = 0.0303).Overall Dizziness Handicap Inventory scores reduced from 45.9 to 27.4 (p < 0.0001), and across all subgroups of functional (p = 0.0003), emotional (p < 0.0001), and physical handicap (p = 0.0005).A 6.4-dB HL improvement in the air-bone gap (500-1000 Hz) occurred (95% confidence intervals 3.3-9.4 dB HL, p < 0.0001). There were no dead ears. cVEMP thresholds, when recordable, normalized in all except two ears | ||
| 520 | |a CONCLUSIONS: Transmastoid occlusion is effective at improving patient-reported outcomes and normalizing cVEMP thresholds, though some symptoms, notably disequilibrium, persist to a variable degree | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Dawe, Nicholas |e verfasserin |4 aut | |
| 700 | 1 | |a Jervis, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Raghu |e verfasserin |4 aut | |
| 700 | 1 | |a Dalton, C Lucy |e verfasserin |4 aut | |
| 700 | 1 | |a Lindley, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Irving, Richard |e verfasserin |4 aut | |
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