Review article Age and gender considerations on the symptomology in patients with superior semicircular canal dehiscence: A systematic review and case illustration Thien Nguyen a , John P. Sheppard a , Courtney Duong a , Kevin Ding a , Dillon Dejam a , Yasmine Alkhalid a , Prasanth Romiyo a , Daniel Azzam a , Giyarpuram Prashant a , Quinton Gopen c , Isaac Yang a,b,c,d,e,f,⇑ a Departments of Neurosurgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States b Departments of Radiation Oncology, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States c Departments of Head and Neck Surgery, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States d Departments of Jonsson Comprehensive Cancer Centre, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States e Departments of Los Angeles Biomedical Research Institute, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States f Departments of Harbor-UCLA Medical Centre, David Geffen School of Medicine of the University of California, Los Angeles (UCLA), Los Angeles, CA, United States article info Article history: Received 8 August 2018 Accepted 12 April 2019 Available online xxxx Keywords: Superior semicircular canal dehiscence Gender Semicircular canals Age abstract Superior semicircular canal dehiscence (SSCD) is caused by a fistula in the arcuate eminence, creating vestibular and auditory disturbances. We aim to determine the effects of gender and age on symptom prevalence and resolution in patients with SSCD. A Boolean search was conducted through four separate scientific databases. Full-text English articles for SSCD patients, who underwent surgery were included. Demographics and outcomes were extracted. A total of 198 patients were identified, and available for quantitative analysis. Between genders, there were no differences in the prevalence of pre- or post- operative symptomology. Both genders had statistically significant improvement in symptomatology with females experiencing significantly high rates of hearing loss improvement compared to male patients. Compared to their younger cohort, patients over 65 had similar symptom frequencies before and after surgery with similar rates of symptom resolution. SSCD repair is safe and effective for resolving auditory and vestibular symptoms. Gender and age may not be strong predictors of patient presentation or symptom resolution. Gender and age-associated factors may not influence patient outcomes. Ó 2019 Published by Elsevier Ltd. 1. Introduction Superior semicircular canal dehiscence (SSCD), first described by Minor et al., is an inner ear disorder arising from a defect between the temporal fossa and superior semicircular canal, now gaining recognition within the neurosurgical sphere [1–6]. Usually, the otic capsule bone surrounding the inner ear contains the round and oval windows. In SSCD, the introduction of a new opening or ‘‘third mobile window,” thought to be caused by the idiopathic thinning of the bone over the superior semicircular canal, causes acoustic and vestibular system abnormalities [7]. Vestibular seque- lae of SSCD include vertigo induced by pressure (Hennebert sign) or sound (Tullio phenomenon), and oscillopsia [7–9]. Auditory symptoms manifest as conductive hearing loss, aural fullness, pul- satile tinnitus, and autophony [7,10,11]. Diagnosis of SSCD includes an extensive medical exam, audiometry, vestibular evoked myo- genic potentials, and neuroimaging (computed tomography or magnetic resonance) to discern thinning of the underlying tempo- ral bone [12]. Patients with debilitating auditory or vestibular symptoms or cannot avoid triggers are candidates for surgery. Two different surgical approaches have been used in practice: transmastoid and middle cranial fossa (MCF). The transmastoid approach involves resurfacing of the superior semi-circular canal through an opening of the mastoid tegmen and lifting the dura, or by plugging of the superior semi-circular canal [3,13]. This approach yields high symptomatic resolution with low complica- tion rates [8,14–16]. Conversely, the MCF approach enables direct visualization of the dehiscence, permitting optimal repair of the defect [17–19]. However, SSCD repair via the MCF approach may cause sensorineural hearing loss (SNHL), with current studies esti- mating SNHL in 25% to 36% of patients following MCF surgery [20]. https://doi.org/10.1016/j.jocn.2019.04.006 0967-5868/Ó 2019 Published by Elsevier Ltd. ⇑ Corresponding author at: Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Ste. 562, Los Angeles, CA 90095-1761, United States. E-mail address: iyang@mednet.ucla.edu (I. Yang). Journal of Clinical Neuroscience xxx (xxxx) xxx Contents lists available at ScienceDirect Journal of Clinical Neuroscience journal homepage: www.elsevier.com/locate/jocn Please cite this article as: T. Nguyen, J. P. Sheppard, C. Duong et al., Age and gender considerations on the symptomology in patients with superior semi- circular canal dehiscence: A systematic review and case illustration, Journal of Clinical Neuroscience, https://doi.org/10.1016/j.jocn.2019.04.006