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S081: SURGICAL MATERIAL SELECTION TO MINIMIZE REVISION RATES IN SUPERIOR SEMICIRCULAR CANAL DEHISCENCE REPAIR: INSIGHTS FROM THE LARGEST DATABASE
Simon Han; Mahlet Mekonnen; Laila Khorasani; Quinton Gopen; Isaac Yang; David Geffen School of Medicine at UCLA

Introduction: Superior semicircular canal dehiscence (SSCD) is a rare neurologic condition affecting <2% of the population. Characterized by a pathologic bony opening in the semicircular canal, SSCD produces debilitating auditory and vestibular symptoms that severely impact quality of life. Surgical repair, via sealing, resurfacing, plugging, or capping, aims to restore physiologic fluid dynamics. Commonly used materials include bone chip, bone flap, bone wax, transversalis fascia, and IQ dome; however, the optimal material combination to minimize revision rates (RR) remains unclear.

Objective: To identify surgical repair material combinations associated with the lowest RR using the largest reported SSCD database to date.

Methods: We performed a retrospective chart review of 600 SSCD repairs performed jointly by a head and neck surgeon and neurosurgeon at UCLA Medical Center (2011–2024). Data collected included demographics, surgical repair materials, and RR. Fisher’s exact test was applied to evaluate differences between material cohorts.

Results: Among 600 SSCD repair cases, material selection demonstrated a measurable impact on revision rates. Repairs using bone chip and bone wax (n = 260) showed a 5% RR (p = 0.04), while repairs with bone wax and IQ dome (n = 224) had an 11.61% RR (p = 0.0057). In comparison, the cohort repaired with bone chip, bone wax, and transversalis fascia (n = 32) had a 9.38% RR, which did not reach statistical significance (p = 0.727). Other material combinations, though represented by smaller sample sizes, demonstrated variability in revision outcomes but lacked sufficient power for definitive statistical conclusions.

Conclusions: This analysis, the largest SSCD surgical outcomes study to date, demonstrates that material selection significantly influences revision rates. Bone chip with bone wax and bone wax with IQ dome were associated with the most significant differences in RR compared to other groups. These findings highlight that specific combinations may offer more reliable long-term durability, informing surgical decision-making for SSCD repair.

 

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