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Tytuł:
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A Basis for Standardizing Superior Semicircular Canal Dehiscence Management.
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Autorzy:
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Cozart AC; University of Central Florida (UCF) College of Medicine, Orlando, FL, USA.
Kennedy JT 3rd; University of Central Florida (UCF) College of Medicine, Orlando, FL, USA.
Seidman MD; Advent Health, Central Florida, Celebration, FL, USA.
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Źródło:
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Ear, nose, & throat journal [Ear Nose Throat J] 2021 Dec; Vol. 100 (10), pp. NP444-NP453. Date of Electronic Publication: 2020 May 21.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Thousand Oaks, CA : SAGE Publications
Original Publication: [New York, Insight Pub. Co.]
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MeSH Terms:
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Otolaryngology/*standards
Semicircular Canal Dehiscence/*diagnosis
Semicircular Canal Dehiscence/*therapy
Semicircular Canals/*pathology
Audiometry, Pure-Tone ; Cranial Fossa, Middle/surgery ; Hearing Aids ; Humans ; Magnetic Resonance Imaging ; Mastoid/surgery ; Practice Patterns, Physicians' ; Semicircular Canal Dehiscence/surgery ; Semicircular Canals/surgery ; Surveys and Questionnaires ; Tomography, X-Ray Computed ; Vestibular Evoked Myogenic Potentials
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Contributed Indexing:
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Keywords: SSCD; labyrinth diseases; management of SSCD; physician survey; superior semicircular canal dehiscence; third-window syndromes
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Entry Date(s):
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Date Created: 20200522 Date Completed: 20211229 Latest Revision: 20220428
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Update Code:
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20240105
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DOI:
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10.1177/0145561320927941
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PMID:
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32436400
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Objectives: (1) To determine how otologic/neurotologic surgeons counsel patients with superior semicircular canal dehiscence (SSCD). (2) To understand the plethora of presenting symptoms associated with SSCD and appropriate management. (3) To suggest appropriate management; oftentimes avoiding surgery.
Methods: This was a survey study of both community and academic physicians. A 23-question survey was distributed to all members of the American Neurotological (ANS) and American Otologic Societies (AOS) via email in the Fall of 2018. A total of 54 responses were received from a possible pool of 279 for a response rate of 19.4%. Inferences were made about the population through sample proportions and confidence intervals.
Results: All respondents use computed tomography (CT) in diagnosing SSCD and 11.1% use CT exclusively. Cervical vestibular evoked myogenic potential (VEMP; 77.8%) are used more often than ocular VEMPs (38.9%). Magnetic resonance imaging (7.4%) is used infrequently; 96.3% of surgeons surveyed have seen patients with SSCD on imaging that are asymptomatic. Following surgical treatment, respondents reported balance issues and mild-to-moderate high-frequency sensorineural hearing loss (88.4%); 32.6% reported that the majority (>50%) of their patients needed further intervention after surgery, typically aggressive vestibular rehabilitation.
Conclusions: There is a discrepancy in the systematic approach to SSCD between both the surgeons and the published literature. Patients with SSCD on ultra-high-resolution CT may have myriad symptoms while others are asymptomatic, and surgery may lead to additional complications. We will present a methodical recommendation to assist in the management of patients with SSCD depending upon their symptoms. This may improve patient selection, counseling, and outcomes.