Risk Factors and Preceding Events Predisposing the Development of Superior Canal Dehiscence Syndrome

Objective: To elucidate risk factors and preceding events for the development of symptoms of superior canal dehiscence syndrome (SCDS). Study design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Adult patients with SCDS who underwent surgical repair. Interventions: Not applicable. Main outcome measures: Data on occupational and recreational histories, inciting events, and presenting symptoms were collected from medical records. Results: Records of 405 patients undergoing 454 surgeries were reviewed. The average age was 48 years; 231 (57%) patients were female. Forty-nine (12%) patients underwent bilateral sequential surgeries. Of those with a reported occupation (n=207), occupational exposures included loud noises in 22% and ambient pressure changes in 23% of patients. Of 56 patients reporting hobbies, 66% included physical exercise (weightlifting, running, etc), and 27% either played an instrument or sang. Scuba diving, flying airplanes, hunting, and farming were each reported once (2%). One hundred seventy-five (43%) patients described preceding events leading to the development of symptoms, subdivided into an internal cause (eg, sneezing or coughing, etc) in 33% of those patients, external trauma (eg, fall, motor vehicle accident, etc) in 32%, an external cause not involving trauma (eg, loud noise exposure, ambient pressure changes such as during scuba diving) in 27%, spontaneously occurring in 5%, and in the immediate aftermath of surgery in 3%. Presenting symptoms were autophony (78%), sound-induced vertigo or oscillopsia (73%), somatosounds (70%), pressure-induced vertigo or oscillopsia (68%), and pulsatile tinnitus (66%). Conclusions: Certain occupational and avocational factors may predispose individuals to SCDS, and certain traumatic events may precipitate its development.