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Superior Semicircular Canal Dehiscence (SSCD)

Superior Semicircular Canal Dehiscence (SSCD) is a rare condition affecting the inner ear, specifically the superior semicircular canal. It disrupts the normal function of the auditory and vestibular systems, leading to a range of auditory and balance-related symptoms. Recognising and understanding this condition is essential for accurate diagnosis and effective management.

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What is SSCD?

SSCD occurs when the bony covering of the superior semicircular canal is abnormally thin or absent. This creates a “third window” in the inner ear, altering how sound and head movements are processed. This anomaly can result from congenital factors, trauma, or conditions that weaken bone integrity, such as osteopenia.

Symptoms of SSCD

Patients with SSCD may experience a variety of symptoms:

  • Auditory Symptoms:
    • Autophony (hearing one’s own voice or bodily sounds unusually loudly).
    • Conductive hearing loss.
    • Hyperacusis (sensitivity to external sounds).
  • Vestibular Symptoms:
    • Vertigo triggered by loud noises (Tullio phenomenon) or pressure changes (Hennebert sign).
    • Imbalance or unsteadiness.
    • Oscillopsia (visual instability caused by head movements).

These symptoms can vary in severity and significantly affect daily life.

How Common is SSCD?

SSCD is uncommon, with imaging studies indicating a prevalence of approximately 0.5-1%. However, not all individuals with this anatomical abnormality experience symptoms. Symptomatic cases are often diagnosed in middle-aged adults but can occur at any age.

Diagnosing SSCD

Accurate diagnosis involves a combination of clinical evaluation, audiological testing, and imaging:

  1. Clinical Evaluation:
    • Detailed history of symptoms such as vertigo, hearing issues, and balance disturbances.
    • Observation of triggers, such as noise or pressure changes.
  2. Audiological Tests:
    • Pure-tone audiometry often reveals a specific pattern of conductive hearing loss.
    • Vestibular Evoked Myogenic Potentials (VEMP) testing shows heightened sensitivity to sound.
  3. Imaging Studies:
    • High-resolution CT scans of the temporal bone confirm the diagnosis by identifying the bony defect.
    • MRI may be used to rule out other conditions or assess associated abnormalities.

Treatment Options & Outcomes

Management of SSCD depends on the severity of symptoms:

  • Conservative Management:
    • Mild cases may be managed through lifestyle changes and avoidance of triggers.
  • Surgical Intervention:
    • For severe symptoms, surgical repair is the preferred approach. Options include:
      • Resurfacing: Covering the dehiscence with bone cement or graft material.
      • Plugging: Sealing the affected canal to stabilise inner ear function.

Both surgical techniques have shown high success rates, with significant symptom relief for most patients.

Superior Semicircular Canal Dehiscence is a complex vestibular condition that requires careful evaluation and tailored treatment. With advances in diagnostic imaging and surgical techniques, individuals with SSCD can achieve improved quality of life. If you experience symptoms like dizziness, hearing changes, or balance issues, consult with a specialist to explore your options.

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