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Home  Superior Semicircular Canal Dehiscence(SCD) Plugging, Rt
Superior Semicircular Canal Dehiscence(SCD) Plugging, Rt
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3D
Prof. Jawon Koo Seoul National University Bundang Hospital | Republic of Korea Speciality : Otorhinolaryngology
16:46

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Published : 2018-05-02  Views : 311 Likes :
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Summary
Superior Semicircular Canal Dehiscence is rare for one of the other canals(three
semicircular canal) to be dehiscent. Surgery can permanently solve the problem.
The surgical operation can either be performed through the trans-mastoid approach
(back of the ear) or through the middle fossa approach (above the ear). The trans-mastoid
approach is done through an incision behind the ear. It does not involve any manipulation
of the brain, and thus is less risky neurologically. However, the mastoid approach is
slightly more risky to the hearing and facial nerve.

The dehiscence in the canal can be plugged, resurfaced or capped. Canal plugging is
to block the fluid flow through the semicircular canals, thereby shutting down the sensors
so that the false sensation of motion is prevented. Abnormal fluid flow causes so much
dizziness and distress that it is better to have no fluid flow than abnormal flow.

The dehiscence, or opening, is caused by a thinning or complete absence of the part of the
temporal bone overlying the superior semicircular canal of the vestibular system, which
is essential to your sense of balance and spatial orientation. Surgical treatment for SSCD
involves one of two approaches: Plugging the canal or resurfacing the canal.
Canal plugging is to block the fluid flow through the semicircular canals, thereby shutting
down the sensors so that the false sensation of motion is prevented. Abnormal fluid flow
causes so much dizziness and distress that it is better to have no fluid flow than abnormal
flow. Transmastoid approach does not involve any manipulation of the brain, and thus is
less risky neurologically. However, the mastoid approach is slightly more risky to the
hearing and facial nerve. The operation is performed the mastoid approach.

The size of dehiscence showed an inverse correlation to the rate of success.


Technique + Approach
- Middle fossa approach
- Transmastoid approach (through an incision behind the ear.

Middle fossa approach
- After the temporalis muscle was identified and reflected
anteroinferiorly and the root of the zygoma was identified. A craniotomy flap at least
3.5cm x 3.5ccm was created at least 2/3 anterior to the level of the external auditory
canal was developed and removed, exposing the temporal lobe dura. The temporal lobe
dura is elevated off the floor of the middle cranial fossa. The position of the superior canal
was identified in or near the area of the arcuate eminence. The dehiscence repaired.


Indications
- Chronic dizziness
- Vertigo
- Hearing loss
- Balance issues
- Visual disturbances
- Other debilitating symptoms
- Patients previously undergoing surgery for otosclerosis
- Patients undergoing exploratory tympanotomy for conductive hearing loss


Contraindications
- Stapedectomy

Complications
- Aural fullness
- Autophony
- Chronic disequilibrium


Patient
Gender
Female

Age
45

■ Microscope : CarlZeiss Pentero

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■ Surgical Drill : B. BRAUN Aesculap

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