Superior Semicircular Canal Dehiscence (SSCD) ; Disabling Symptoms; Dr. Isaac Yang

SUMMARY: Dr. Isaac Yang, a Neurosurgeon and Skull base specialist describes his involvement with an understanding the scientific basis of a disabling disease which up until recently was undiagnosed and treated. Patients who presented with symptoms of autophony (hearing ones voice, body sounds, eye movements, breathing) so loudly that they drive the patient into isolation from others. If one couples these symptoms with dizziness and imbalance (not true vertigo)  and with normal routine studies (angiograms, CT of Brain and even petrous bone) it is  understandable  how these patients are believed to have a psychiatric illness.  Yet, with his colleagues in Neuro-Otology, led by Neuro-Otologist Dr. Minor,, who related these symptoms to a semicircular canal disease these investigators studied hundreds of patients, defining the characteristics which would help select the patients for surgery. In addition to the audiologic testing,  fine (0.6mm) cuts of the temporal bone revealed a separation in the bone of the middle fossa over the Superior Semicircular Canal in the ear, which was highly correlated to the symptoms of the patients.  Called Superior Semicircular Canal Dehiscence (SSCD), repair of this bony defect has led to a rapid disappearance of the disabling symptoms. Dr. Yang, who was initially skeptical of this disease, now has become deeply involved in the research on the problem as have a group of others in major centers in the world. The surgical repair is described, which involves a skull base neurosurgeon and neuro-otologist. The risks of surgery, now done  through a burr hole opening,  are 1% including infection. More research has found categories of lesser degrees of dehiscence that can lead to relief of symptoms. Dr. Yang provides an excellent review of this disease process and gives advice on how to diagnose it and find locations to treat it. For neurologists, otolaryngologists, neurosurgeons. This is a very interesting story of the History of Medicine and many other diseases.    (71) minutes. (JIA)

Speaker
  • James I. Ausman, MD, MA, PhD

    CEO SNI and SNI Digital; Emeritus Professor Neurosurgery

  • Isaac Yang, MD

    Professor, Neurosurgery, Radiation Oncology, Head and Neck Surgery