2026 Proffered Presentations
S229: PREDICTORS OF SYMPTOMATIC IMPROVEMENT AFTER SURGICAL REPAIR OF SUPERIOR SEMICIRCULAR CANAL DEHISCENCE IN OVER 600 CASES
Laila N Khorasani, BS; Mahlet Mekonnen, BS; Simon Han, BS; Quinton Gopen, MD; Isaac Yang; UCLA
Superior Semicircular Canal Dehiscence (SSCD) is an anatomical defect of the superior semicircular canal, leading to a pathologic connection between the inner ear and brain. This defect may be present in up to 3% of the population and can contribute to several vestibular and auditory deficits. Definitive treatment of SSCD is surgical repair, typically via middle cranial fossa approach. Surgical repair of SSCD has been shown to improve clinical disease. However, specific selection measures and conditions that enable most robust improvement are currently unknown. As such, we present a database of 634 SSCD cases in adults, where we conduct a retrospective analysis on the demographic and medical factors that contribute to surgical repair outcomes. All cases were performed at UCLA-Ronald Reagan medical center by two surgeons between the years 2011 and 2024. In our study, patients reported autophony, tinnitus, and dizziness as most common pre-operative symptoms. The average age of patients was 50.4 years (range: 19-85) and 35.8% of patients were male. Sex does not play a role in symptom improvement, however increased age is associated with greater reported improvements in hearing in patients with pre-operative hearing loss (p=0.0005). History of ear pathology is another important predictor of improvement. Specifically, patients with a positive history are less likely to report improvement in autophony (p=0.02), aural fullness (p=0.004), and hyperacusis (p=0.006). This effect was reversed in patients reporting improvement in dizziness (p=0.01), indicating a potential distinction in the interplay between vestibular and auditory symptoms. Additionally, history of head trauma is positively associated with improvement in headache post-operatively (p=0.005). Our work confirms an overall positive effect of surgical repair on vestibular and auditory symptoms of SSCD. Interestingly, older patients garnered a greater increase in benefit on hearing as a result of surgery compared to younger patients. Additionally, patients with a history of inner ear pathology are less likely to see a benefit in auditory symptoms as a result of surgery, potentially due to the secondary effect of an underlying ear anomaly not addressed by SSCD repair. Further research is necessary to further parse out the contributing factors of symptom presentation as a result of SSCD, as well as investigate the specific surgical approaches that enable the most significant symptom reduction.