Can we enhance the Accuracy of Third Window Syndrome?

Esteban-Sánchez J, Sanz R and Martín-Sanz E

Department of Otolaryngology, University Hospital of Getafe, Toledo km. 12500 28905 Getafe (Madrid), Spain

^*Correspondance to: Eduardo Martin-Sanz 

 PDF  Full Text DOI: 10.25107/2474-1647.1018

Abstract

Introduction: Minor described a syndrome characterized by auditory and vestibular symptoms such as tinnitus, autophony and dizziness provoked by loud sounds or manipulation of auditory external canal. Diagnosis is based in computed tomography to demonstrate a dehiscence of the arcuate eminence. Recent studies show that there are radiological images of dehiscence of superior semicircular canal (SSC) but surgical findings demonstrate a thin bone cover. Many authors demonstrate that there are audiological and electrophysiological changes in VEMPs and EchoG in patients with Third Window Syndrome (TWS), which could enhance the accuracy of the diagnosis.Material and
Methods: We present a retrospective study of 30 patients (39 affected ears) of radiological dehiscence of the semicircular canal. 19 of them have clinical symptoms of TWS (clinical cohort) and 20 have just radiological evidence of the dehiscence without clinical manifestations (radiological cohort). Both cohorts underwent a complete audiological and electrophysiological (cervical and ocular VEMPs at 500 Hz and 1000 Hz and Electrocochleography (EchoG)) studies.Results: Presence of cervical and ocular VEMPs, elicited with 500 and 1000 Hz, were significantly greater in the clinical cohort than the radiological group. Thresholds of cVEMPs at 500 Hz and 1000 Hz and o-VEMPs at 1000 Hz are statistically significant lower in the clinical cohort. Amplitude of c-VEMPs at 500 Hz were greater in clinical cohort than the radiological one. No significant differences were found in the EchoG findings between both groups.Conclusions: VEMPs results can help to make a better accuracy of TWS. EchoG can’t differentiate patients with TWS of those with only a radiological dehiscence.

Keywords

Vertigo; Third window syndrome; Superior semicircular canal; VEMPs; Extratympanic EchoG

Cite the article

Esteban-S�nchez J, Sanz R, Mart�n- Sanz E. Can we enhance the Accuracy of Third Window Syndrome? Clin Surg. 2016; 1: 1018.