Semicircular canal dehiscence among idiopathic intracranial hypertension patients

Phoebe Kuo; Kenneth A Bagwell; Gino Mongelluzzo; Christopher A Schutt; Ajay Malhotra; Babar Khokhar; John F Kveton

doi:10.1002/lary.26795

Semicircular canal dehiscence among idiopathic intracranial hypertension patients

Laryngoscope. 2018 May;128(5):1196-1199. doi: 10.1002/lary.26795. Epub 2017 Aug 22.

Authors

Phoebe Kuo¹, Kenneth A Bagwell¹, Gino Mongelluzzo², Christopher A Schutt³, Ajay Malhotra⁴, Babar Khokhar⁵, John F Kveton¹

Affiliations

¹ Department of Surgery-Otolaryngology, Yale School of Medicine, New Haven, Connecticut, U.S.A.
² Department of Radiology, Geisinger Medical Center, Danville, Pennsylvania, U.S.A.
³ Michigan Ear Institute, Farmington Hills, Michigan, U.S.A.
⁴ Department of Radiology, Yale School of Medicine, New Haven, Connecticut, U.S.A.
⁵ Department of Neurology, Yale School of Medicine, New Haven, Connecticut, U.S.A.

PMID: 28833207
DOI: 10.1002/lary.26795

Abstract

Objectives/hypothesis: The cause of superior semicircular canal dehiscence (SSCD) is unknown. Because of a demonstrated association with tegmental defects and obesity, some have suggested idiopathic intracranial hypertension (IIH) could contribute by eroding the bone over the canal and resulting in SSCD. However, an association between IIH and SSCD has not previously been evaluated. Our objective was to evaluate an association between IIH and SSCD.

Study design: Retrospective cohort.

Methods: A retrospective study was performed of opening pressures for consecutive patients presenting at a lumbar puncture clinic between August 2012 and October 2015. Imaging for patients who also had thin-sectioned computed tomography (CT) imaging was reviewed for the presence of radiographic SSCD. Association between IIH and SSCD was evaluated using the Student t test and multivariate logistic regression.

Results: One hundred twenty-one patients had both a lumbar puncture performed and thin-sectioned CT imaging available, of which 24 patients (19.8%) met the criteria for IIH with an opening pressure >25 cm H₂ O. The remaining 97 patients (80.2%) did not have elevated opening pressures and served as the control cohort. None of the 24 patients with IIH had radiographic SSCD, whereas eight of the 97 patients (8.2%) without IIH had radiographic SSCD. The average opening pressure in patients without radiographic SSCD was 20.2 cm H₂ O compared to 19.3 cm H₂ O in patients with radiographic SSCD (P = .521). In multivariate logistic regression controlling for age, body mass index, gender, and comorbidities (hypertension, diabetes, hyperlipidemia), opening pressure was not a significant predictor of radiographic SSCD.

Conclusions: The results of this retrospective pilot study do not suggest an association between IIH and SSCD.

Level of evidence: 3b. Laryngoscope, 128:1196-1199, 2018.

Keywords: Superior semicircular canal dehiscence; idiopathic intracranial hypertension; opening pressure; tegmen erosion.

MeSH terms

Adult
Aged
Female
Humans
Male
Middle Aged
Pilot Projects
Pseudotumor Cerebri / complications*
Retrospective Studies
Semicircular Canals / diagnostic imaging
Semicircular Canals / pathology*
Tomography, X-Ray Computed