Semicircular canal dehiscence among idiopathic intracranial hypertension patients

• Published in: The Laryngoscope 2018-05, Vol.128 (5), p.1196-1199
• Main Authors: Kuo, Phoebe, Bagwell, Kenneth A., Mongelluzzo, Gino, Schutt, Christopher A., Malhotra, Ajay, Khokhar, Babar, Kveton, John F.
• Format: Article
• Language: English
• Subjects: Hypertension; idiopathic intracranial hypertension; Medical imaging; opening pressure; Superior semicircular canal dehiscence; tegmen erosion
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.26795

Objectives/Hypothesis The cause of superior semicircular canal dehiscence (SSCD) is unknown. Because of a demonstrated association with tegmental defects and obesity, some have suggested idiopathic intracranial hypertension (IIH) could contribute by eroding the bone over the canal and resulting in SSCD. However, an association between IIH and SSCD has not previously been evaluated. Our objective was to evaluate an association between IIH and SSCD. Study Design Retrospective cohort. Methods A retrospective study was performed of opening pressures for consecutive patients presenting at a lumbar puncture clinic between August 2012 and October 2015. Imaging for patients who also had thin‐sectioned computed tomography (CT) imaging was reviewed for the presence of radiographic SSCD. Association between IIH and SSCD was evaluated using the Student t test and multivariate logistic regression. Results One hundred twenty‐one patients had both a lumbar puncture performed and thin‐sectioned CT imaging available, of which 24 patients (19.8%) met the criteria for IIH with an opening pressure >25 cm H2O. The remaining 97 patients (80.2%) did not have elevated opening pressures and served as the control cohort. None of the 24 patients with IIH had radiographic SSCD, whereas eight of the 97 patients (8.2%) without IIH had radiographic SSCD. The average opening pressure in patients without radiographic SSCD was 20.2 cm H2O compared to 19.3 cm H2O in patients with radiographic SSCD (P = .521). In multivariate logistic regression controlling for age, body mass index, gender, and comorbidities (hypertension, diabetes, hyperlipidemia), opening pressure was not a significant predictor of radiographic SSCD. Conclusions The results of this retrospective pilot study do not suggest an association between IIH and SSCD. Level of Evidence 3b. Laryngoscope, 128:1196–1199, 2018