Accuracy of computed tomography detection of superior canal dehiscence

Sunitha M. Sequeira, Bruce R. Whiting, Joshua S. Shimony, Katie D. Vo, Timothy Hullar

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Hypothesis: High-resolution temporal bone computed tomography (CT) may erroneously demonstrate a superior semicircular canal dehiscence (SSCD) where none exists and inaccurately display the size of a dehiscence. Background: CT is an integral component of the diagnosis of SSCD. The prevalence of dehiscence as measured on computed tomographic scan is approximately eightfold higher than that on histologic studies, suggesting that CT may have a relatively low specificity for identifying canal dehiscence. This, in turn, can lead to an inappropriate diagnosis and treatment plan. Methods: We quantified the accuracy of CT in identifying a dehiscence of the superior semicircular canal in a cadaver model using microCT as a gold standard. The superior canals of 11 cadaver heads were blue lined. Twelve of the 22 ears were further drilled to create fenestrations of varying sizes. Heads were imaged using medical CT, followed by microCT scans of the temporal bones at 18-μm resolution. Diagnosis of dehiscence and measurements of dehiscence size were performed on clinical CT and compared with that of microCT. Results: Clinical CT identified 7 of 8 intact canals as dehiscent and tended to overestimate the size of smaller fenestrations, particularly those surrounded by thin bone. Conclusion: These findings confirm that medical CT cannot be used as the exclusive gold standard for SSCD and that, particularly for small dehiscences on CT, clinical symptoms must be clearly indicative of a dehiscence before surgical treatment is undertaken. Preoperative counseling for small dehiscences may need to include the possibility that no dehiscence may be found despite radiologic evidence for it.

Original languageEnglish (US)
Pages (from-to)1500-1505
Number of pages6
JournalOtology and Neurotology
Volume32
Issue number9
DOIs
StatePublished - Dec 2011
Externally publishedYes

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Tomography
Semicircular Canals
X-Ray Microtomography
Temporal Bone
Cadaver
Head
Ear
Counseling
Bone and Bones

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

Accuracy of computed tomography detection of superior canal dehiscence. / Sequeira, Sunitha M.; Whiting, Bruce R.; Shimony, Joshua S.; Vo, Katie D.; Hullar, Timothy.

In: Otology and Neurotology, Vol. 32, No. 9, 12.2011, p. 1500-1505.

Research output: Contribution to journalArticle

Sequeira, Sunitha M. ; Whiting, Bruce R. ; Shimony, Joshua S. ; Vo, Katie D. ; Hullar, Timothy. / Accuracy of computed tomography detection of superior canal dehiscence. In: Otology and Neurotology. 2011 ; Vol. 32, No. 9. pp. 1500-1505.
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