scholarly journals Superior Canal Dehiscence Length and Location Influences Clinical Presentation and Audiometric and Cervical Vestibular-Evoked Myogenic Potential Testing

2014 ◽  
Vol 19 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Marlien E.F. Niesten ◽  
Leena M. Hamberg ◽  
Joshua B. Silverman ◽  
Kristina V. Lou ◽  
Andrew A. McCall ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Canal Dehiscence

scholarly journals Toward Optimizing cVEMP: 2,000-Hz Tone Bursts Improve the Detection of Superior Canal Dehiscence

2018 ◽  
Vol 23 (6) ◽  
pp. 335-344 ◽  
Author(s):  
Kimberley S. Noij ◽  
Barbara S. Herrmann ◽  
John J. Guinan Jr. ◽  
Steven D. Rauch
Keyword(s):  
Roc Analysis ◽  
Matched Control ◽  
Tone Burst ◽  
Sound Level ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Inferior Vestibular Nerve ◽  
Canal Dehiscence

Background: The cervical vestibular evoked myogenic potential (cVEMP) test measures saccular and inferior vestibular nerve function. The cVEMP can be elicited with different frequency stimuli and interpreted using a variety of metrics. Patients with superior semicircular canal dehiscence (SCD) syndrome generally have lower cVEMP thresholds and larger amplitudes, although there is overlap with healthy subjects. The aim of this study was to evaluate which metric and frequency best differentiate healthy ears from SCD ears using cVEMP. Methods: Twenty-one patients with SCD and 23 age-matched controls were prospectively included and underwent cVEMP testing at 500, 750, 1,000 and 2,000 Hz. Sound level functions were obtained at all frequencies to acquire threshold and to calculate normalized peak-to-peak amplitude (VEMPn) and VEMP inhibition depth (VEMPid). Third window indicator (TWI) metrics were calculated by subtracting the 250-Hz air-bone gap from the ipsilateral cVEMP threshold at each frequency. Ears of SCD patients were divided into three groups based on CT imaging: dehiscent, thin or unaffected. The ears of healthy age-matched control subjects constituted a fourth group. Results: Comparing metrics at all frequencies revealed that 2,000-Hz stimuli were most effective in differentiating SCD from normal ears. ROC analysis indicated that for both 2,000-Hz cVEMP threshold and for 2,000-Hz TWI, 100% specificity could be achieved with a sensitivity of 92.0%. With 2,000-Hz VEMPn and VEMPid at the highest sound level, 100% specificity could be achieved with a sensitivity of 96.0%. Conclusion: The best diagnostic accuracy of cVEMP in SCD patients can be achieved with 2,000-Hz tone burst stimuli, regardless of which metric is used.

Vestibular-Evoked Myogenic Potential Testing in Vestibular Localization and Diagnosis

2020 ◽  
Vol 40 (01) ◽  
pp. 018-032 ◽  
Author(s):  
Rachael L. Taylor ◽  
Miriam S. Welgampola ◽  
Benjamin Nham ◽  
Sally M. Rosengren
Keyword(s):  
Vestibular System ◽  
Vestibular Evoked Myogenic Potentials ◽  
Vestibular Disorders ◽  
Complementary Information ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Superior Canal Dehiscence ◽  
Otolith Function ◽  
Utricular Function ◽  
Canal Dehiscence

AbstractVestibular-evoked myogenic potentials (VEMPs) are short-latency, otolith-dependent reflexes recorded from the neck and eye muscles. They are widely used in neuro-otology clinics as tests of otolith function. Cervical VEMPs are recorded from the neck muscles and reflect predominantly saccular function, while ocular VEMPs are reflexes of the extraocular muscles and reflect utricular function. They have an important role in the diagnosis of superior canal dehiscence syndrome and provide complementary information about otolith function that is useful in the diagnosis of other vestibular disorders. Like other evoked potentials, they can provide important localizing information about lesions that may occur along the VEMP pathway. This review will describe the VEMP abnormalities seen in common disorders of the vestibular system and its pathways.

scholarly journals Superior Semicircular Canal Dehiscence Syndrome: Review of Clinical Manifestations in Adults and Children

2009 ◽  
Vol 24 (2) ◽  
pp. 6-13
Author(s):  
Scheherazade C. Ibrahim ◽  
Charlotte M. Chiong ◽  
Nathaniel W. Yang
Keyword(s):  
Semicircular Canal ◽  
Clinical Manifestations ◽  
Case Series ◽  
Vestibular Evoked Myogenic Potential ◽  
Superior Semicircular Canal Dehiscence ◽  
Computed Tomographic ◽  
Myogenic Potential ◽  
Superior Semicircular Canal ◽  
Computed Tomographic Scan ◽  
Canal Dehiscence

Objective: This report aims to determine the clinical manifestations and management of patients with superior semicircular canal dehiscence syndrome (SSCDS). Methods: Study Design: Case series. Setting: Tertiary hospitals and private clinics Participants: Out of 30 patients with vestibular vertigo or otologic symptom, 14 patients were diagnosed with SSCDS based on high resolution computed tomographic scan (HRCT).  The demographic features, incidence of specific signs and symptoms and management of these patients were described, including the audiograms, vestibular evoked myogenic potential (VEMP) responses and ancillary tests. Results: Vertigo was the most common vestibular symptom of SSCDS. Tullio phenomenon was elicited in 50% of patients with confirmed dehiscence on HRCT scan. Low frequency (250 Hz and 500 Hz) air-bone gap was noted in 21.4% of patients. Lowered VEMP responses were also noted in 66.7% of patients with confirmed SSCDS. Severity of symptoms may determine its management. Conclusion: The diagnosis of SSCDS does not conform to a specific clinical presentation or audiologic result thus good clinical correlation is needed in order to raise suspicion of the disease and prompt the clinician to order confirmatory imaging by computed tomographic scan or magnetic resonance imaging. The presence of this syndrome in a proportion of children that is greater than previously reported needs further study as these children may be genetically predisposed to have thinned out superior semicircular canals that eventually become dehisced albeit at an earlier age. Key words: Superior semicircular canal dehiscence, pure tone audiometry, vestibular evoked myogenic potential

Surgical treatment of posterior semicircular canal dehiscence syndrome caused by jugular diverticulum

2012 ◽  
Vol 126 (9) ◽  
pp. 928-931 ◽  
Author(s):  
H W Lim ◽  
H J Park ◽  
J H Jung ◽  
J W Chung
Keyword(s):  
Surgical Treatment ◽  
Semicircular Canal ◽  
Jugular Bulb ◽  
Clinical Findings ◽  
Posterior Semicircular Canal ◽  
Vestibular Evoked Myogenic Potential ◽  
Myogenic Potential ◽  
Defect Site ◽  
Potential Threshold ◽  
Canal Dehiscence

AbstractObjective:We report a rare case of posterior semicircular canal dehiscence caused by a jugular diverticulum, and we describe its surgical treatment using a dehiscence resurfacing manoeuvre.Method:The clinical findings, surgical procedure and outcomes are presented.Results:A 66-year-old man presented with disequilibrium, sound-induced vertigo, a reduced ocular vestibular evoked myogenic potential threshold, and pressure-induced vertical and torsional nystagmus. Computed tomography revealed a right posterior semicircular canal dehiscence caused by a diverticulum of the jugular bulb. The defect in the posterior semicircular canal was localised and resurfaced with bone paté, temporalis muscle fascia and conchal cartilage, under direct visualisation. Post-operatively, the patient's symptoms disappeared and his ocular vestibular evoked myogenic potential threshold normalised.Conclusion:This case illustrates that posterior semicircular canal dehiscence can be surgically managed by resurfacing the defect site via a transmastoid approach.

scholarly journals Current Trends, Controversies, and Future Directions in the Evaluation and Management of Superior Canal Dehiscence Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristine Elisabeth Eberhard ◽  
Divya A. Chari ◽  
Hideko Heidi Nakajima ◽  
Mads Klokker ◽  
Per Cayé-Thomasen ◽  
...  
Keyword(s):  
Primary Repair ◽  
Bone Conduction ◽  
Signs And Symptoms ◽  
Diagnostic Techniques ◽  
Bony Defect ◽  
Vestibular Evoked Myogenic Potential ◽  
High Resolution Computed Tomography ◽  
Superior Canal Dehiscence ◽  
Testing Algorithm ◽  
Canal Dehiscence

Patients with superior canal dehiscence syndrome (SCDS) can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of the superior semicircular canal (SSC). Over the past two decades, advances in diagnostic techniques have raised the awareness of SCDS and treatment approaches have been refined to improve patient outcomes. However, a number of challenges remain. First, there is currently no standardized clinical testing algorithm for quantifying the effects of superior canal dehiscence (SCD). SCDS mimics a number of common otologic disorders and established metrics such as supranormal bone conduction thresholds and vestibular evoked myogenic potential (VEMP) measurements; although useful in certain cases, have diagnostic limitations. Second, while high-resolution computed tomography (CT) is the gold standard for the detection of SCD, a bony defect does not always result in signs and symptoms. Third, even when SCD repair is indicated, there is a lack of consensus about nomenclature to describe the SCD, ideal surgical approach, specific repair techniques, and type of materials used. Finally, there is no established algorithm in evaluation of SCDS patients who fail primary repair and may be candidates for revision surgery. Herein, we will discuss both contemporary and emerging diagnostic approaches for patients with SCDS and highlight challenges and controversies in the management of this unique patient cohort.

Sign in / Sign up

Export Citation Format

Share Document