Surgical treatments for a case of superior canal dehiscence syndrome associated with patulous Eustachian tube

Ryoukichi Ikeda, Hiromitsu Miyazaki, Masahiro Morita, Daisuke Yamauchi, Tetsuaki Kawase, Yukio Katori, Toshimitsu Kobayashi

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objectives: The patulous Eustachian tube (PET) and superior semicircular canal dehiscence syndrome (SCDS) have similarity in their symptoms and similar effects caused by positional changes, causing difficulty in the differentiation between the two disorders. This report describes a case of both SCDS and PET that was eventually successfully treated. Methods: A 68-year-old man presented with hyperacusis to his own footsteps and gait disturbance. He had been diagnosed as PET two years before and had been treated by insertion of a silicone plug (Kobayashi plug) at the other hospital. Clinical case records, audiological data, cervical vestibular-evoked myogenic potential (cVEMP), Eustachian tube function tests and computed tomography (CT) were taken in the sitting position. Results: While the CT confirmed superior semicircular canal dehiscence, the results of cVEMP was not typical of SCD likely due to preexisting hearing impairment in the right ear with a history of middle ear surgeries for the treatment of PET. He received round window reinforcement (RWR) and achieved relief from his symptoms but six months after the surgery, he visited again with complaints of autophony of his own voice and breathing. The tympanic membrane was found to move synchronous with respiration, and Eustachian tube function tests and the sitting CT confirmed the recurrence of severe PET. He had his silicone plug exchanged (increase in size of the Kobayashi plug) and achieved relief from symptoms. Conclusions: The present case was a rare instance showing that PET and SCDS can occur simultaneously in a patient. The patient achieved relief from symptoms after treatment with RWR and insertion of the Kobayashi plug.

Original languageEnglish
Pages (from-to)630-635
Number of pages6
JournalAuris Nasus Larynx
Volume46
Issue number4
DOIs
Publication statusPublished - 2019 Aug

Keywords

  • Patulous Eustachian tube
  • Round window reinforcement
  • Silicone plug
  • Superior semicircular canal dehiscence syndrome

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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