Süperior Semisirküler Kanal Dehissansı Olgularında oVEMP ve cVEMP Değerlendirmesi

Yıl 2024, Cilt: 6 Sayı: 1, 206 - 214, 25.04.2024

Ceren Uğur Yeşim Gizem Ertürk Bahriye Horasanlı

https://doi.org/10.46413/boneyusbad.1401029

Öz

Süperior semisirküler kanal dehissansı, süperior semisirküler kanalın üzerini örten kemik tabakanın eksikliği veya zamanla incelip erimesi sonucunda oluşan odyovestibüler sistemin bir hastalığıdır. Hastalık, kemik tabakanın olmayışı nedeniyle iç kulakta oval ve yuvarlak pencere dışında üçüncü bir pencere oluşturur. Oluşan üçüncü pencere nedeniye saf ses odyometri testi sonrası kemik yolu eşiklerini azaltan yalancı iletim tipi işitme kaybı (psödo-konduktif) gözlenir. Vestibüler uyarılmış miyojenik potansiyeller ise akustik bir uyarana, boyun veya göz kaslarının verdiği cevapların elektrotlar aracılığıyla kaydedildiği elektrofizyolojik bir ölçüm yöntemidir. Kullanım amacı, vestibuler son organlar olan urtikül ve sakkülün fonksiyonlarını değerlendirmektir. En patognomonik olduğu hastalık semisirküler kanal dehissansı olmakla birlikte birincil amacı semisirküler kanal dehissansının tanısını koydurmaktır. Bu derlemede, son on yılın araştırmaları esas alınmış olup; süpeior semisirküler kanal dehissansı (SSKD) olgularında, oküler vestibüler uyarılmış miyojenik potansiyeller (oVEMP) ve servikal vestibüler uyarılmış miyojenik potansiyeller (cVEMP) testlerinin tanısal sonuçları değerlendirilmiştir. Çalışmalar, SSKD olgularında etkilenen tarafta Cvemp testi eşiklerinde anormal düşüşleri ifade etmektedir. Ayrıca oVEMP amplitüdünde, etkilenen tarafta belirgin bir artışta bildirilmiştir. Sonuçlar; bu iki testin birlikte değerlendirmeye alınmasının, semisirküler kanal dehisansı olgularına tanısal anlamda katkı sunacağını göstermektedir.

Anahtar Kelimeler

SSCD, cVEMP, oVEMP, Psödo-konduktif işitme kaybı

Evaluation of oVEMP and cVEMP in Superior Semicircular Canal Dehiscence Cases

Öz

Superior semisircular canal dehiscence (SSCD) is a disease of the audiovestibular system, which occurs as a result of the lack of bone layer covering the superior semisircular canal. The disease forms a third window in the inner ear due to the lack of bone layer. The third window that occurs forms a pseudo conductive type of hearing loss, which has decreased bone thresholds in the audiometry test. Vestibular evoked myogenic potentials are an electrophysiological measurement method in which the responses of the neck or eye muscles to an acoustic stimulus are recorded by means of electrodes. The purpose of use is to evaluate the functions of the urticle and saccule, which are the vestibular end organs. Therefore its primary purpose is to diagnose semicircular canal dehiscence. This review is based on research from the last decade; diagnostic results of ocular vestibular evoked myogenic potentials (oVEMP) and cervical vestibular evoked myogenic potentials (cVEMP) tests were evaluated in cases of superior semicircular canal dehiscence (SSCD). Studies indicate abnormal decreases in cVEMP test thresholds on the affected side in SSCD cases. Additionally, a significant increase in oVEMP amplitude on the affected side has been reported. Results; It shows that evaluating these two tests together will contribute to the diagnosis of semicircular canal dehiscence cases.

Anahtar Kelimeler

Superior semicircular canal dehiscence, Cervical vestibular evoked myogenic potentials, Ocular vestibular evoked myogenic potentials

Kaynakça

• Adams, M. E., Kileny, P. R., Telian, S. A., El-Kashlan, H. K., Heidenreich, K. D., Mannarelli, G. R., & Arts, H. A. (2011). Electrocochleography as a diagnostic and intraoperative adjunct in superior semicircular canal dehiscence syndrome. Otology & Neurotology, 32(9), 1506-1512. doi:10.1097/MAO.0b013e3182382a7c
• Arts, H. A., Adams, M. E., Telian, S. A., El-Kashlan, H., & Kileny, P. R. (2009). Reversible electrocochleographic abnormalities in superior canal dehiscence. Otology & Neurotology, 30(1), 79-86. doi:10.1097/MAO.0b013e31818d1b51
• Belgin, E., & Şahlı, A. S. (2017). Temel Odyoloji 2. Güneş Tıp Kitabevi.
• Berning, A. W., Arani, K., & Branstetter, B. F. (2019). Prevalence of superior semicircular canal dehiscence on high-resolution CT imaging in patients without vestibular or auditory abnormalities. American Journal of Neuroradiology, 40(4), 709-712. doi: 10.3174/ajnr.A5999
• Çeliker, F., Özgür, A., Çeliker, M., Beyazal, M., Turan, A., Terzi, S. (2018). The efficacy of magnetic resonance imaging for the diagnosis of superior semicircular canal dehiscence. J Int Adv Otol. 2018;14(1):68-71.
• Carey, J. P., Minor, L. B., & Nager, G. T. (2000). Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Archives of otolaryngology–head & neck surgery, 126(2), 137-147. doi:10.1001/archotol.126.2.137
• Crane, B. T., Lin, F. R., Minor, L. B., & Carey, J. P. (2010). Improvement in autophony symptoms after superior canal dehiscence repair. Otology & Neurotology, 31(1), 140-146. doi:10.1097/MAO.0b013e3181bc39ab
• Çeliker, F., Özgür, A., Çeliker, M., Beyazal, M., Turan, A., Terzi, S. (2018). The efficacy of magnetic resonance imaging for the diagnosis of superior semicircular canal dehiscence. The Journal of International Advanced Otology, 14(1), 68-71. doi:10.5152/iao.2017.4103
• Evren, C., Demirbilek, N. & Küfeciler, L. (2021). Odyometri Atlası. Nobel Tıp Kitabevleri, İstanbul. ISNB: 978-605-335-646-2.
• Goplen, F. K., Hess-Erga, J., Opheim, L. R., Silvola, J. T., Stene, B. K., Törpel, J., ... & Bunne, M. (2022). Buegangsdehiscens. Tidsskrift for Den norske legeforening. 2(1). doi:10.4045/tidsskr.21.0426
• Govender, S., Fernando, T., Dennis, D. L., Welgampola, M. S., & Colebatch, J. G. (2016). Properties of 500 Hz air-and bone-conducted vestibular evoked myogenic potentials (VEMPs) in superior canal dehiscence. Clinical Neurophysiology, 127(6), 2522-2531. doi:10.1016/j.clinph.2016.02.019.
• Göçer, C., & Kayalı Dinç, A., (2019). Superior Semisirküler Kanal Dehissansı. KBB ve BBC Dergisi, 27(2):70-5. doi:10.24179/kbbbbc.2019-64731
• Grieser, B. J. (2015). Fluid-mechanical model for vestibular responses to sound in presence of a superior canal dehiscence. In Institute of Fluid Dynamics, ETH Zurich. doi:10.3929/ethz-a-10435235
• Hassannia, F., Misale, P., Harvey, K., Yu, E., & Rutka, J. A. (2021). Elevated ocular VEMP responses in the absence of a superior semicircular canal dehiscence. American Journal of Otolaryngology, 42(1), 102789. doi:10.1016/j.amjoto.2020.102789
• Ho, M. L., Moonis, G., Halpin, C. F., & Curtin, H. D. (2017). Spectrum of third window abnormalities: semicircular canal dehiscence and beyond. American Journal of Neuroradiology, 38(1), 2-9. doi: 10.3174/ajnr.A4922
• Hunter, J. B., O'Connell, B. P., Wang, J., Chakravorti, S., Makowiec, K., Carlson. M. L., … Wanna, G. B. (2016). Correlation of superior canal dehiscence surface area with vestibular evoked myogenic potentials, audiometric thresholds, and dizziness handicap. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 37(8), 1104. doi: 10.1097/MAO.0000000000001126.
• Hunter, J. B., Patel, N. S., O’Connell, B. P., Carlson, M. L., Shepard, N. T., McCaslin, D. L., & Wanna, G. B. (2017). Cervical and ocular VEMP testing in diagnosing superior semicircular canal dehiscence. Otolaryngology–Head and Neck Surgery, 156(5), 917-923. doi:10.1177/0194599817690720
• Janky, K. L., Zuniga, M. G., Schubert, M. C., & Carey, J. P. (2015). The effect of increased intracranial pressure on vestibular evoked myogenic potentials in superior canal dehiscence syndrome. Clinical Neurophysiology, 126(4), 780-786. doi: 10.1016/j.clinph.2014.06.049
• Lin, K., Lahey, R., Beckley, R., Dennis Bojrab, I. I., Wilkerson, B., Johnson, E., ... & Hong, R. S. (2019). Validating the utility of high frequency ocular vestibular evoked myogenic potential testing in the diagnosis of superior semicircular canal dehiscence. Otology & Neurotology, 40(10), 1353-1358. doi: 10.1097/MAO.0000000000002388
• Maheu, M., Elblidi, A., & Saliba, I., (2021). Investigating Performance of cVEMP and oVEMP in the Identification of Superior Canal Dehiscence in Relation to Dehiscence Location and Size. Audiology Research, 11: 452–462. doi: 10.3390/audiolres11030042
• Merchant, S. N., & Rosowski, J. J. (2008). Conductive hearing loss caused by third-window lesions of the inner ear. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 29(3), 282.9. doi: 10.1097/MAO.0b013e318161ab24
• Minor, L.B. (2005). Clinical manifestations of superior semicircular canal dehiscence. The Laryngoscope, 115(10), 1717-1727. doi: 10.1097/01.mlg.0000178324.55729.b7
• Minor L.B., Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N. (2001). Symptoms and signs in superior canal dehiscence syndrome. Annals of the New York Academy of Sciences. 942:259–273. doi: 10.1111/j.1749-6632.2001.tb03751.x
• Musiek, F. E., Shinn, J. B., Baran, J. A., & Jones, R. O. (2020). Disorders of the auditory system. Plural Publishing. United Kingdom.
• Niesten, M. E., McKenna, M. J., Herrmann, B. S., Grolman, W., & Lee, D. J. (2013). Utility of cVEMPs in bilateral superior canal dehiscence syndrome. The Laryngoscope, 123(1), 226-232. doi:10.1002/lary.23550
• Noij, K. S., & Rauch, S. D. (2020). Vestibular evoked myogenic potential (VEMP) testing for diagnosis of superior semicircular canal dehiscence. Frontiers in Neurology, 11, 695. doi:10.3389/fneur.2020.00695
• Piker, E. (2014). Update on cVEMP and oVEMP testing in superior canal dehiscence. Canadian Audiologist, 1(4). https://canadianaudiologist.ca/update-on-cvemp-and-ovemp-testing-in-superior-canal-dehiscence/
• Rosengren, S. M., Colebatch, J. G., Young, A. S., Govender, S., & Welgampola, M. S. (2019). Vestibular evoked myogenic potentials in practice: Methods, pitfalls and clinical applications. Clinical neurophysiology practice, 4, 47-68. doi:10.1016/j.cnp.2019.01.005
• Sepúlveda, I., Schmidt, T., & Platín, E. (2014). Use of cone beam computed tomography in the diagnosis of superior semicircular canal dehiscence. Journal of Clinical Imaging Science, 4. doi:10.4103/2156-7514.141554
• Sood, D., Rana, L., Chauhan, R., Shukla, R., & Nandolia, K. (2017). Superior semicircular canal dehiscence: a new perspective. European journal of radiology open, 4, 144-146. doi:10.1016/j.ejro.2017.10.003
• Su, H.C., Huang, T.W., Young, Y.H., Cheng, P.W. (2004). Aging effect on vestibular evoked myogenic potential. Otology & Neurotology, 25(6):977–80. doi:10.1097/00129492-200411000-00019
• Todd, N. P. M., Rosengren, S. M., Aw, S. T., & Colebatch, J. G. (2007). Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air-and bone-conducted sound. Clinical Neurophysiology, 118(2), 381-390. doi:10.1016/j.clinph.2006.09.025
• Ward, B. K., Carey, J. P., & Minor, L. B. (2017). Superior canal dehiscence syndrome: lessons from the first 20 years. Frontiers in neurology, 8, 177. doi:10.3389/fneur.2017.00177
• Ward, B. K., Van De Berg, R., Van Rompaey, V., Bisdorff, A., Hullar, T. E., Welgampola, M. S., & Carey, J. P. (2021). Superior semicircular canal dehiscence syndrome: diagnostic criteria consensus document of the committee for the classification of vestibular disorders of the Bárány Society. Journal of Vestibular Research, 31(3), 131-141. doi:10.3233/VES-200004
• Weber, P. (2008). Vertigo and Disequilibrium. A Practical Guide to Diagnosis and Management. New York: Thieme, 125-9. doi: 10.1016/B9780323034326.500052
• Zhang, L., Creighton, F.X., & Carey, J.P., (2021). A Cohort Study Comparing Importance of Clinical Factors in Determining Diagnosis and Treatment for Superior Semicircular Canal Dehiscence Syndrome. Otology & Neurotology, 42(9): 1429-143. doi: 10.1097/MAO.0000000000003274
• Zuniga, M. G., Davalos-Bichara, M., Schubert, M. C., Carey, J. P., & Janky, K. L. (2014). Optimizing ocular vestibular evoked myogenic potential testing for superior semicircular canal dehiscence syndrome: electrode placement. Audiology and Neurotology, 19(4), 239-247. doi:10.1159/000360124
• Zuniga, M. G., Janky, K. L., Nguyen, K. D., Welgampola, M. S., & Carey, J. P. (2013). Ocular vs. cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otology & Neurotology, 34(1), 121. doi:10.1097/MAO.0b013e31827136b0