Last week we discussed the physiology behind symptoms associated with Superior Canal Dehiscence Syndrome (SCDS). This week, we look at some of the symptoms associated with this condition. While many patients with SCDS complain of chronic dyequilibrium and disorientation, there are some symptoms that are more specific to SCDS.
Mass Eye and Ear describes the symptoms as: patients with SCDS will often describe a sensation of oscillopsia, or eyes “jumping up and down,” or vertigo in the “vertical plane.” The horizon will move up and down during the episode.
In 2005, Dr. Lloyd Minor published a paper titled “Clinical Manifestations of Superior Semicircular Canal Dehiscence.” In that paper, he reports on a series of 65 patients who were considered to be symptomatic based on SCDS identified by high resolution CT scan of the temporal bone. Not all patients had the same symptoms, or the same triggers for symptoms. Here are their findings:
Tullio phenomenon- 90% of patients complained of vestibular symptoms when exposed to loud noises.
Hennebert’s sign –pressure induced symptoms were noted in 73%. This could include symptoms brought on by coughing, sneezing, straining, blowing the nose, etc.
Auditory manifestations they describe as “conductive hyperacusis”, where they feel that internally generated sounds such as their heartbeat and pulse, chewing and own voice art abnormally loud. They report “Conductive hyperacusis included symptoms such as hearing eye movements in the affected ear and hearing the impact of feet during walking or running” were present in 52% of patients in this study. Autophony in the affected ear was present in 60%.
Subjective hearing loss or fullness –Mass Eye and Ear describes this as :
Fullness of one or both ears – often a patient with SCDS will complain that the ear with the dehiscence feels blocked or full.
Next week, we will explore some of the clinical sign associated with SCDS.
Photo courtesy of dariuskohandmd.com
