ABSTRACT
OBJECTIVES: We assessed the prevalence of superior semicircular canal dehiscence (SSCD) through examination of ultrahigh-resolution computed tomography (CT) scans of the temporal bone and attempted to verify the correspondence between a radiologic diagnosis of SSCD and clinical signs of SSCD syndrome. METHODS: A prospective study was carried out on 191 consecutive patients who underwent temporal bone ultrahigh-resolution CT scans. Cases that matched the radiologic diagnosis of SSCD were subsequently referred for a comprehensive audiological evaluation that might enable a final diagnosis of SSCD syndrome. RESULTS: Among the 191 patients, 17 had a radiologic diagnosis of SSCD, which was bilateral in 5 cases, for a total of 22 SSCD cases, with a prevalence rate of 5.8%. In 2 of the 17 patients, the audiological examination revealed signs and symptoms indicative of SSCD syndrome, with a total prevalence rate of 0.5%. CONCLUSIONS: Our data confirm that the radiologic diagnosis of SSCD, performed by mean thin-section CT scans reformatted in the plane of the superior semicircular canal, is not necessarily related to the clinical presentation of SSCD syndrome. Our study also showed a prevalence rate of SSCD syndrome that was similar to the prevalence of SSCD reported from studies of histologic specimens.
Subject(s)
Ear Diseases/diagnostic imaging , Multidetector Computed Tomography , Semicircular Canals/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Ear Diseases/pathology , Evoked Potentials, Auditory , Female , Humans , Male , Middle Aged , Prospective Studies , SyndromeABSTRACT
The aim of this study was to compare the incidence of complications of endoscopic sinus surgery (ESS) to the incidence of complications of traditional and microscopic sinus surgery. A meta-analysis was carried out on 28 series of patients (a total of 13,405) who had undergone ESS, 8 series of patients (3,887 in total) who had undergone traditional endonasal sinus surgery and 7 series of patients (1,630 in total) who had undergone microscopic sinus surgery. The authors used the Bayesian inference package WinBUGS operating from within the statistical computer program R (version 2.7.1). Major complications had a higher incidence after traditional sinus surgery than ESS but this fact did not cause a significant statistical difference, whereas microscopic surgery had significantly more complications than ESS (p < 0.05). Carrying out our meta-analytic study, comparing major and minor complications of endonasal surgical approaches, was very difficult due to several methodological biases of data extraction and evaluation from studies concerning a broad timespan. Regarding major complications, we only found a significant statistical difference (p < 0.05) between the endoscopic (1%) and the microscopic methods (2.0%), but, if we had analyzed the data considering the natural learning curve of the latest ESS surgical approach, and if we had not considered the results produced in the first 10 years (1988-1998) concerning ESS in our meta-analysis, we would have found a statistically significant difference (p < 0.05) between the endoscopic (0.4%) and the traditional (1.1%) approach as well.
