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Unveiling the importance of the endoscope in the sealing of the superior canal dehiscence syndrome, how we do it
Importancia del endoscopio en el sellado de la dehiscencia del canal semicircular superior
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Carlos Doval-Rosaa,
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cadoro30@gmail.com

Corresponding author.
, Francisco Javier Dorado-Capotea, Alvaro Toledano-Delgadoa, Jose Miguel Sequí-Sabaterb, Román Carlos-Zamorac, Juan Solivera-Velaa
a Reina Sofía University Hospital, Córdoba, Spain
b Rheumatology Department, La Ribera University Hospital, Alzira, Valencia, Spain
c Otorhinolaryngology department, Reina Sofía University Hospital, Córdoba, Spain
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Received 05 February 2024. Accepted 05 May 2024
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Abstract

The superior canal dehiscence syndrome is a pathology that affects the arcuate eminence creating a “third window” between the inner ear and the middle fossa. This condition can lead to symptoms such as hearing loss, autophony, or sound-induced vertigo. Traditionally, surgical treatment has been performed by microscope-assisted temporal craniotomy, but when the dehiscence is in the medial part of the arcuate eminence the bone defect may not be seen.

We present case series treated at our institution diagnosed of superior canal dehiscence syndrome involving the medial slope of the arcuate eminence. During surgery, the bone defect could not be visible with traditional microscopic techniques. Nonetheless, by introducing the endoscope with the 0º and 30º optics, the dehiscence could be clearly observed and treated correctly.

Our results show a clinical improvement without side effects or complications in the patients undergoing this technique. Endoscope-assisted surgery is a safe procedure and provides a better visualization of medial defects.

Keywords:
Arcuate eminence
Endoscope-assisted surgery
Medial defect
Superior canal dehiscence
Resumen

La dehiscencia del canal semicircular superior es una patología que afecta a la eminencia arcuata creando una "tercera ventana" entre el oído interno y la fosa media. Este defecto puede provocar síntomas como pérdida de audición, autofonía o vértigo inducido por el sonido. Tradicionalmente, el tratamiento quirúrgico se ha realizado mediante craneotomía temporal asistida por microscopio, pero cuando la dehiscencia se encuentra en la parte medial de la eminencia arcuata el defecto óseo puede no verse.

Presentamos una serie de casos intervenidos en nuestro centro diagnosticados de dehiscencia del canal semicircular superior que afecta a la pendiente medial de la eminencia arqueada. Durante la cirugía, el defecto óseo no pudo ser visible con las técnicas microscópicas tradicionales. Sin embargo, al introducir el endoscopio con óptica de 0º y 30º se pudo observar claramente la dehiscencia y tratarla correctamente.

Nuestros resultados muestran una mejoría clínica sin complicaciones en los pacientes sometidos a esta técnica. La cirugía asistida por endoscopio es un procedimiento seguro y proporciona una mejor visualización de los defectos mediales.

Palabras clave:
Eminencia arcuate
Cirugía asistida por endoscopio
Defecto medial
Dehiscencia del canal semicircular superior

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