Characterizing the Predictive Power of Reported Auditory Symptom Resolution in the Immediate Postoperative Period for Superior Canal Dehiscence Syndrome.

OBJECTIVE

To determine if auditory symptom relief in the immediate post-operative period predicts long-term relief for patients with superior canal dehiscence syndrome (SCDS).

STUDY

DESIGN

Prospective cohort study.

SETTING

Tertiary referral center.

PATIENTS: Adults who underwent unilateral SCDS surgery between June 2021 and June 2023.

INTERVENTION: Surgery for SCDS.

MAIN OUTCOME MEASURES: Patient-reported symptoms from preoperative, immediate postoperative (<24 h), and longer-term postoperative (12 wk) visits. Postoperative symptoms were categorized as no improvement from pre-operation, some relief, significant relief, and complete relief.

RESULTS

Fifty-six patients underwent unilateral SCDS surgery (37 left, 19 right). The majority were female (71.4%, n=40), with an average age of 47.2 years (SD=9.9). Forty-seven (83.9%) surgical approaches were middle fossa and 9 (16.1%) were transmastoid. Preoperative auditory symptoms of autophony, somatosounds, and pulsatile tinnitus were reported by 98.2%, 96.4%, and 73.2% of patients, respectively. For autophony, 52 (94.5%) patients reported significant or complete symptomatic relief at 12 weeks. Of these, 100% reported at least some relief of autophony within 24 hours of surgery. One patient reported no improvement of their autophony within 24 hours, but subsequently some relief at 12 weeks. Somatosounds showed similar response rates at 12 weeks (96.3%) with all patients reporting improvement at 24 hours. Pulsatile tinnitus responses suggested delayed improvement with 70.7% reporting significant or complete relief at 12 weeks, only 44.8% of whom reported improvement at 24 hours.

CONCLUSIONS

Auditory symptom improvement in the immediate post-operative period strongly predicts longer-term auditory symptom relief in SCDS, though improvement in pulsatile tinnitus often lags.