Secondary Reinforcement of the Round Window to Treat Residual Hyperacusis in Patients With Superior Semicircular Canal Dehiscence Syndrome.

OBJECTIVE

To report long-term outcomes for patients undergoing round window reinforcement (RWR) surgery as a second operation for hyperacusis symptoms in superior semicircular canal dehiscence (SSCD) syndrome.

METHODS

Retrospective case series of the RWR cases performed by the senior author at our tertiary center between 2013 and 2024. All patients underwent RWR surgery using the same technique, and the primary SSCD occlusion was also performed by the senior author.

RESULTS

Three patients were included in this case series. The mean interval between primary SSCD occlusion surgery and RWR was 25 months. The mean length of follow-up post-RWR surgery was 50 months. All patients reported resolution of their hyperacusis symptoms in the operated ear at the time of the last follow-up. One patient developed a degree of manageable imbalance and difficulty with hearing with background noise, 1 patient developed hyperacusis on the contralateral side but remained asymptomatic on the side of the operated ear, and 1 patient remained asymptomatic of SSCD at 8 years post-RWR but developed symptoms suggestive of Meniere's disease, which was well controlled with diet and betahistine. Hearing outcomes were variable, with 2 out of 3 patients reporting a mild worsening of hearing loss post-RWR.

CONCLUSIONS

Patients with hyperacusis symptoms demonstrated resolution of their symptoms after RWR in the operated ear. Careful patient selection is required, and patients need to be informed about the potential for postoperative hearing loss as part of informed decision-making.