hearing your eyes move syndrome

What to Do When You Hear Your Eye Move?

What would your reaction be if a patient stated they heard their eyeball move?  They might also report that they get dizzy when loud sounds occur (Tullio phenomenon) and when they move their head quickly from one side to the other. They could also report aural fullness, autophony (echo or reverberation of the ear when speaking chewing or swallowing, hearing ones own heart beat) and maybe even some hearing loss.  This cluster of symptoms is quite puzzling and frustrating for the affected person and the diagnosis can be difficult.

In 1998, Dr. Lloyd Minor, a physician from Johns Hopkins, described superior canal dehiscence syndrome (SCDS or SCD) which can cause hearing difficulties, balance issues, or both.  The cause is due to an opening in the bone overlying one of the inner ear balance canals due to congenital defect, trauma or infection.

Audiometrically, a low to mid-frequency (250-1,000 Hz) conductive hearing loss can be present, but with no supporting evidence of middle ear involvement. The conductive loss associated with SCDS not only shows air/bone gaps at these frequencies but also a hypersensitivity of bone conduction thresholds– as low as -5dB HL at 250-500 with decreasing sensitivity as the frequency increases.  The thinning or absence of the bone on the superior canal creates an additional window in the inner ear, along with the round and oval windows.  This “third window” allows for air conductive (AC)  sound energy to be diverted away from the cochlea, decreasing the pressure between the scala vestibuli and scala tympani.  The “third window” will not depress bone conductive (BC) thresholds, but will enhance them.

 

Superior Canal Dehiscence Syndrome Often Misdiagnosed

 

This condition is easily misdiagnosed  as it can masquerade as several conditions such as Eustachian tube dysfunction, patulous Eustachian tube, Benighn proxysmal positional verigo (BPPV), Meniere’s disease, Vestibular Neuronitis/neuritis, Perilymph fistula and Labyrinthitis.

The diagnosis can be confirmed with high resolution CT scans of the temporal bone, reformatted to the planes parallel and perpendicular to the superior canals.  In the world of radiology these are called the Poeschel and Stenver planes.  As you look at this scan, you will see the Superior Canal on the left, the bone is not connecting on the top portion as it should be.

Depending on how SCDS is affecting the quality of life for the affected person, treatments include: hearing aid for the affected side, avoidance of loud sounds; surgery (middle fossa craniotomy, transmastoid repair).  Surgical risks include hearing loss (12% of cases) and reoccurring SCDS.


About Judy Huch

7 Comments

  1. Thank you Judy, and Dan, do i fit in with the implant group? i looked on FB however its closed. I certainly do not want to intrude on the group when i’ve never had an implant.

  2. Kerry, see Dan’s response as well to give you another resource. The only way the SCDS can be diagnosed is with a high resolution CT scan. If this has not been conducted, you may want to talk with your ENT specialist for this possibility. But no, not an oddity and hopefully you can find answers.

  3. By the way, this alone anwers questions i have alway’s had. Guess i’m not such an oddity or am I?

  4. I can hear my eyeball move, also, i can report aural fullness, autophony (echo or reverberation of the ear when speaking chewing or swallowing, hearing ones own heart beat) and maybe even some hearing loss. I have also had 4 chlosteotoma surgery’s 3 in my right ear and just recently 1 on my left ear. could this all be related somehow?

  5. “What would your reaction be if a patient stated they heard their eyeball move?”

    It’s called “gaze tinnitus” and it’s common among NF2 patients.

    There’s the Auditory Brainstem Implant Technology group on Facebook, where about 70 ABI users, candidates & parents of candidates congregate with about 20 hearing care professionals as the only gathering spot on the Internet for ABI discussions. Gaze tinnitus has come up; and in fact some sufferers have said it’s been dismissed by their various medical providers.

    Dan Schwartz

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