Importance Superior semicircular canal dehiscence syndrome (SSCDS) can manifest with significant vestibular and auditory symptoms. For patients with debilitating SSCDS symptoms, surgical repair can be performed using a middle cranial fossa (MCF) or transmastoid (TM) approach, however, comparisons of outcomes between surgical approaches are unclear. Objective To assess outcomes in SSCD repaired using either MCF or TM surgical approaches. Design Systematic review and meta-analysis. Setting A systematic search of all articles reporting on the presence of outcomes of SSCD repair in Medline, Embase, CINAHL, Scopus, and Web of Science databases. Participants 1130 patients with SSCDS reported in 34 manuscripts. Exposure/Intervention Surgical repair of SSCD via MCF or TM approaches. Main Outcome Measures Rates of post-operative improvement in subjective auditory and vestibular symptoms as well as changes in objective audiometric measures air-conduction (AC), bone-conduction (BC), and air-bone gaps (ABG) pure-tone averages. Results Patients were highly likely (60%-95%) to report improvement in audiological and vestibular symptom improvement following either technique. No differences were observed between surgical approaches, with the exception of oscillopsia 91.1% vs 61.7%; aOR = 6.40; 95% CI = (1.66-24.66); P = .007. No significant post-operative objective changes in audition were observed (AC thresholds, BC thresholds or ABG). Conclusion Outcomes of SSCD surgery are excellent. Most patients report significant improvement or resolution of their pre-operative symptoms, with only minor differences in symptom resolution observed across approaches. Relevance Our results provide evidence that surgical correction of SSCD through MCF and TM approaches is effective. supporting individualized decision-making based on surgeon experience and patient factors.
Urichuk et al. (Sun,) studied this question.