Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
Functional and Radiological Profile of Spontaneous Autoplugging in Superior Canal Dehiscence.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Djian Cassandre, Hautefort Charlotte, Herman Philippe, Trandafir Cornelia, Vallée Jean-Noël, Eliezer Michael
Аннотация
OBJECTIVE: To characterize the clinical, radiologic, and electrophysiological features of spontaneous autoplugging in superior semicircular canal dehiscence (SSCD) and compare them to untreated and surgically treated cases.
METHODS: This retrospective observational study was conducted in a tertiary referral center in Paris, France. Fifty-nine SSCD ears were categorized into 3 groups: untreated (n=36), autoplugging (n=5), and surgically plugged (n=18). Autoplugging was defined as the absence of a fluid signal in the dehiscent canal on high-resolution 3D T2-weighted MRI in patients with no history of ear surgery. All patients underwent clinical assessment, audiometry, video head impulse test (vHIT), cervical vestibular-evoked myogenic potentials (cVEMP), and high-resolution imaging. Group comparisons used nonparametric tests with FDR correction and power analysis.
RESULTS: vHIT gain was significantly reduced in both the autoplugging (0.56 ± 0.09) and surgical groups (0.57 ± 0.13) compared with untreated SSCD (0.77 ± 0.19, P =0.0003). The reduction was confined to the superior canal, whereas lateral and posterior canal gains remained normal. Autophony persisted in the autoplugging group (80%) but was significantly reduced in the surgical group (22.2%, P <0.0001). cVEMP thresholds were abnormally low in untreated (62.0 ± 11.1 dB) and autoplugging ears (62.5 ± 9.6 dB), and significantly higher post-surgery (83.5 ± 12.3 dB, P <0.001).
CONCLUSION: Autoplugging mimics surgical plugging in terms of canal dysfunction but fails to alleviate third-window symptoms. It may represent an incomplete, spontaneous adaptation in SSCD pathophysiology.
LEVEL OF EVIDENCE: Level 3.
METHODS: This retrospective observational study was conducted in a tertiary referral center in Paris, France. Fifty-nine SSCD ears were categorized into 3 groups: untreated (n=36), autoplugging (n=5), and surgically plugged (n=18). Autoplugging was defined as the absence of a fluid signal in the dehiscent canal on high-resolution 3D T2-weighted MRI in patients with no history of ear surgery. All patients underwent clinical assessment, audiometry, video head impulse test (vHIT), cervical vestibular-evoked myogenic potentials (cVEMP), and high-resolution imaging. Group comparisons used nonparametric tests with FDR correction and power analysis.
RESULTS: vHIT gain was significantly reduced in both the autoplugging (0.56 ± 0.09) and surgical groups (0.57 ± 0.13) compared with untreated SSCD (0.77 ± 0.19, P =0.0003). The reduction was confined to the superior canal, whereas lateral and posterior canal gains remained normal. Autophony persisted in the autoplugging group (80%) but was significantly reduced in the surgical group (22.2%, P <0.0001). cVEMP thresholds were abnormally low in untreated (62.0 ± 11.1 dB) and autoplugging ears (62.5 ± 9.6 dB), and significantly higher post-surgery (83.5 ± 12.3 dB, P <0.001).
CONCLUSION: Autoplugging mimics surgical plugging in terms of canal dysfunction but fails to alleviate third-window symptoms. It may represent an incomplete, spontaneous adaptation in SSCD pathophysiology.
LEVEL OF EVIDENCE: Level 3.