Jacob B Hunter1, Brendan P O'Connell, Jianing Wang, Srijata Chakravorti, Katie Makowiec, Matthew L Carlson, Benoit Dawant, Devin L McCaslin, Jack H Noble, George B Wanna. 1. *The Otology Group of Vanderbilt University, Department of Otolaryngology-Head and Neck Surgery†Department of Electrical Engineering and Computer Science‡Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee§Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota||Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Abstract
OBJECTIVE: To correlate objective measures of vestibular and audiometric function as well as subjective measures of dizziness handicap with the surface area of the superior canal dehiscence (SCD). STUDY DESIGN: Retrospective chart review and radiological analysis. SETTING: Single tertiary academic referral center. PATIENTS: Preoperative computed tomography imaging, patient survey, audiometric thresholds, and vestibular evoked myogenic potential (VEMP) testing in patients with confirmed SCD. INTERVENTION(S): Image analysis techniques were developed to measure the surface area of each SCD in computed tomography imaging. MAIN OUTCOME MEASURE(S): Preoperative ocular and cervical VEMPs, air and bone conduction thresholds, air-bone gap, dizziness handicap inventory scores, and surface area of the SCD. RESULTS: Fifty-three patients (mean age 52.7 yr) with 84 SCD were analyzed. The median surface area of dehiscence was 1.44 mm (0.068-8.23 mm). Ocular VEMP amplitudes (r = 0.61, p <0.0001), cervical VEMP amplitudes (r = 0.62, p <0.0001), air conduction thresholds at 250 Hz (r = 0.25, p = 0.043), and air-bone gap at 500 Hz (r = 0.27, p = 0.01) positively correlated with increasing size of dehiscence. An inverse relationship between cervical VEMP thresholds (r = -0.56, p < 0.0001) and surface area of the dehiscence was observed. No association between dizziness handicap and surface area was identified. CONCLUSION: Among patients with confirmed SCD, ocular and cervical VEMP amplitudes, cervical VEMP thresholds, and air conduction thresholds at 250 Hz are significantly correlated with the surface area of the dehiscence.
OBJECTIVE: To correlate objective measures of vestibular and audiometric function as well as subjective measures of dizziness handicap with the surface area of the superior canal dehiscence (SCD). STUDY DESIGN: Retrospective chart review and radiological analysis. SETTING: Single tertiary academic referral center. PATIENTS: Preoperative computed tomography imaging, patient survey, audiometric thresholds, and vestibular evoked myogenic potential (VEMP) testing in patients with confirmed SCD. INTERVENTION(S): Image analysis techniques were developed to measure the surface area of each SCD in computed tomography imaging. MAIN OUTCOME MEASURE(S): Preoperative ocular and cervical VEMPs, air and bone conduction thresholds, air-bone gap, dizziness handicap inventory scores, and surface area of the SCD. RESULTS: Fifty-three patients (mean age 52.7 yr) with 84 SCD were analyzed. The median surface area of dehiscence was 1.44 mm (0.068-8.23 mm). Ocular VEMP amplitudes (r = 0.61, p <0.0001), cervical VEMP amplitudes (r = 0.62, p <0.0001), air conduction thresholds at 250 Hz (r = 0.25, p = 0.043), and air-bone gap at 500 Hz (r = 0.27, p = 0.01) positively correlated with increasing size of dehiscence. An inverse relationship between cervical VEMP thresholds (r = -0.56, p < 0.0001) and surface area of the dehiscence was observed. No association between dizziness handicap and surface area was identified. CONCLUSION: Among patients with confirmed SCD, ocular and cervical VEMP amplitudes, cervical VEMP thresholds, and air conduction thresholds at 250 Hz are significantly correlated with the surface area of the dehiscence.
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