An evidenced-based diagnostic tool for superior semicircular canal dehiscence syndrome

• Published in: Journal of otology (Beijing) 2023-10, Vol.18 (4), p.230-234
• Main Authors: Fritz, Christian G., Casale, Garrett G., Kana, Lulia A., Hong, Robert S.
• Format: Article
• Language: English
• Subjects: Clinical predictors; Diagnostic tool; SSCD; Superior semicircular canal dehiscence; Third window
• ISSN: 1672-2930; 2524-1753
• DOI: 10.1016/j.joto.2023.09.006

To construct a symptoms-based prediction tool to assess the likelihood of superior canal dehiscence (SSCD) on high-resolution CT. Mathematical modeling was employed to predict radiologic evidence of SSCD at a tertiary neurotology referral center. A total of 168 patients were included, of which 118 had imaging-confirmed SSCD. On univariate analysis significant predictors of SSCD presence were: sound/pressure-induced vertigo (p = 0.006), disequilibrium (p = 0.008), hyperacusis (p = 0.008), and autophony (p = 0.034). Multivariate analysis enabled a 14-point symptom-weighted tool to be developed, wherein a score of ≥6 raised the suspicion of SSCD (≥70% likelihood of being present), R2 = 0.853. The likelihood of SSCD on CT scan can be determined with a high degree of certainty based on symptoms recorded at presentation. Using the evidenced-based diagnostic tool validated herein, a score ≥6 with any symptom combination justifies ordering a CT scan. •The likelihood of SSCD on CT scan can be determined based on symptomatology.•A diagnostic tool to facilitate evidenced-based management was developed and validated.•Any combination of symptoms with a score ≥6 using this device may be used to justify ordering a CT scan.