Transmastoid Repair of Superior Semicircular Canal Dehiscence

Superior semicircular canal (Sup SC) dehiscence syndrome (SSCDS) is a recently recognized syndrome. It consists of a variety of auditory symptoms including autophony, hyperacusis, tinnitus, as well as vestibular symptoms of soundinduced and pressure-induced vertigo. These symptoms arise as a result of the third mobile window effect from a dehiscence of the Sup SC. Since its first description in 1998,1 the surgical management of this condition has been a middle cranial fossa, extradural approach to resurface the Sup SC.2,3 While this approach is effective in treating the symptoms, it is not without potential complications. It has been demonstrated that plugging of the dehiscent canal provides more effective symptom control than resurfacing without increased sensorineural hearing loss. While resurfacing of the Sup SC does require an extradural middle cranial fossa approach, plugging of the canal can be achieved via a transmastoid approach avoiding the need for a craniotomy and temporal lobe retraction.4–6 In view of this, our practice has changed