Risk Factors and Preceding Events Predisposing the Development of Superior Canal Dehiscence Syndrome.

OBJECTIVE

To elucidate risk factors and preceding events for the development of symptoms of superior canal dehiscence syndrome (SCDS).

STUDY

DESIGN

Retrospective cohort study.

SETTING

Tertiary referral center.

PATIENTS: Adult patients with SCDS who underwent surgical repair.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Data on occupational and recreational histories, inciting events, and presenting symptoms were collected from medical records.

RESULTS

Records of 405 patients undergoing 454 surgeries were reviewed. The average age was 48 years; 231 (57%) patients were female. Forty-nine (12%) patients underwent bilateral sequential surgeries. Of those with a reported occupation (n=207), occupational exposures included loud noises in 22% and ambient pressure changes in 23% of patients. Of 56 patients reporting hobbies, 66% included physical exercise (weightlifting, running, etc), and 27% either played an instrument or sang. Scuba diving, flying airplanes, hunting, and farming were each reported once (2%). One hundred seventy-five (43%) patients described preceding events leading to the development of symptoms, subdivided into an internal cause (eg, sneezing or coughing, etc) in 33% of those patients, external trauma (eg, fall, motor vehicle accident, etc) in 32%, an external cause not involving trauma (eg, loud noise exposure, ambient pressure changes such as during scuba diving) in 27%, spontaneously occurring in 5%, and in the immediate aftermath of surgery in 3%. Presenting symptoms were autophony (78%), sound-induced vertigo or oscillopsia (73%), somatosounds (70%), pressure-induced vertigo or oscillopsia (68%), and pulsatile tinnitus (66%).

CONCLUSIONS

Certain occupational and avocational factors may predispose individuals to SCDS, and certain traumatic events may precipitate its development.