I would like to discuss the case of a male patient, 45 years old, with history of intermitent tinnitus in the right side for the last two years. The patient complains of tinnitus worsening during physiscal activities (reported as pulsatile in such situations), associated with oscillopsia, even in fast walk. Also complains of short episodes of vertigo in physical efforts and when he gets up.
He does not remind any head trauma occurred recently. He has no complain about his hearing abilities, but in audiometry there is a right side mild sensorineural hearing loss just at 6 and 8khz. No airbone gap. A VEMPc was requested, but we still don't have the results.
We investigated with a CT scan (attached) that shows a Superior Semicircular Canal Dehiscence at a different location, posteriorly, next to the common crus.
I would like to ask the colleagues the following questions:
- Do you have experiences with patients like this one?
- Would you operate this patient? What is the risk for the hearing/vestibular funcion?
- Which is the best access for treating this uncommon location of dehiscence? Transmastoid? Are there difficulties expected?
- Which technique should be used? Canal plugging? Canal ressurfacing (at the posterior fossa??)?? With which material/grafts?