Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
Skull Base Deficiency in Superior Semicircular Canal Dehiscence (SSCD): Evidence for Incomplete Development.
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Schneider William R, Totten Douglas J, Elms Hunter L, Graner Brian D, Yates Charles W, Cumpston Evan C, Nelson Rick F
Аннотация
OBJECTIVE: Determine whether Superior semicircular canal dehiscence (SSCD) patients have thinner skull bases compared with controls and spontaneous cerebrospinal fluid leak (sCSFL) patients.
STUDY DESIGN: Case control.
SETTING: Tertiary referral center.
PATIENTS: Radiographically confirmed SSCD, temporal bone sCSFL, matched (BMI and age), and unmatched control cohorts.
INTERVENTION: Measurement of calvarium, zygomatic arch, and lateral skull base thickness.
MAIN OUTCOME MEASURES: Compare BMI, average skull base, calvarial, and zygomatic arch thicknesses of controls and sCSFL patients.
RESULTS: SSCD patients have an average [SD] BMI similar to unmatched controls (29.2 [7.7] vs. 31.4 [7.9] kg/m 2 , P =0.18), but significantly lower BMI than sCSFL patients (29.2 [7.7] vs. 38.5 [10.6] kg/m 2 , P <0.001). The average skull base thickness of SSCD patients was 50% thinner than matched control patients (2.12 [0.92] vs. 4.23 [1.13] mm, P <0.001, Cohen d =2.05) and 33% thinner than sCSFL patients (2.12 [0.92] vs. 3.13 [1.46] mm, P <0.001, Cohen d =0.83). No significant difference in skull base thickness was observed between symptomatic and asymptomatic SSCD patients ( P =0.45). SSCD patients had a small yet significantly reduced calvarium to zygomatic arch thickness ratio compared with controls (0.44 [0.09] vs. 0.51 [0.11], P <0.001, Cohen d =0.70), but not sCSFL patients (0.44 [0.09] vs. 0.47 [0.12], P =0.09).
CONCLUSIONS: SSCD patients possess dramatically thinner skull bases than control and sCSFL patients, despite a lack of predisposing factors like obesity. These data implicate a developmental deficiency in the pathophysiology of SSCD.
STUDY DESIGN: Case control.
SETTING: Tertiary referral center.
PATIENTS: Radiographically confirmed SSCD, temporal bone sCSFL, matched (BMI and age), and unmatched control cohorts.
INTERVENTION: Measurement of calvarium, zygomatic arch, and lateral skull base thickness.
MAIN OUTCOME MEASURES: Compare BMI, average skull base, calvarial, and zygomatic arch thicknesses of controls and sCSFL patients.
RESULTS: SSCD patients have an average [SD] BMI similar to unmatched controls (29.2 [7.7] vs. 31.4 [7.9] kg/m 2 , P =0.18), but significantly lower BMI than sCSFL patients (29.2 [7.7] vs. 38.5 [10.6] kg/m 2 , P <0.001). The average skull base thickness of SSCD patients was 50% thinner than matched control patients (2.12 [0.92] vs. 4.23 [1.13] mm, P <0.001, Cohen d =2.05) and 33% thinner than sCSFL patients (2.12 [0.92] vs. 3.13 [1.46] mm, P <0.001, Cohen d =0.83). No significant difference in skull base thickness was observed between symptomatic and asymptomatic SSCD patients ( P =0.45). SSCD patients had a small yet significantly reduced calvarium to zygomatic arch thickness ratio compared with controls (0.44 [0.09] vs. 0.51 [0.11], P <0.001, Cohen d =0.70), but not sCSFL patients (0.44 [0.09] vs. 0.47 [0.12], P =0.09).
CONCLUSIONS: SSCD patients possess dramatically thinner skull bases than control and sCSFL patients, despite a lack of predisposing factors like obesity. These data implicate a developmental deficiency in the pathophysiology of SSCD.