Superior Semicircular Canal Dehiscence Syndrome: The Ottawa Hospital Experience
Bibliographic record
Abstract
Objective : Superior semicircular canal dehiscence (SSCD) syndrome has been defined as the absence of bone overlying the superior semicircular canal facing toward the dura of the middle cranial fossa. This bony defect creates a direct communication between the dura and labyrinthine membranous structure, leading to disruption of physiological pressure gradient within the membranous structures and acts as a mobile third window. SSCD patients present hyperacusis, autophony, disequilibrium, and sound- or pressure-induced vertigo. Apart from the avoidance of aggravating factors, there is no effective medical treatment for SSCD. Therefore, surgical management aims to eliminate the communication between the dura and inner ear structures either by reconstructing the skull base or sealing the bony defect over the petrous bone. Methods: We retrospectively review our experience in managing patients with SSCD with middle cranial fossa approach with six-layer reconstruction. Patients who were diagnosed with SSCD according to clinical symptoms, vestibular evoked myogenic potentials (VEMP), high-resolution CT scan, and had an audiology assessment were included in the study. In addition, postoperative clinical data, audiometry, and VEMP responses were collected and analyzed. Results: Twenty patients met the inclusion criteria for this study. 61% of the patients were female. Most of the patients (80%) showed alleviation of vestibular symptoms, whereas a small percentage of patients continued with complications including benign paroxysmal positional vertigo (5%). No sensorineural hearing loss, infections, or intracranial complications were reported and no patient required reoperation. Conclusion: Surgical repair of superior semicircular canal dehiscence through middle cranial fossa approach is highly effective for auditory and vestibular symptom improvement and is associated with relatively low complications. Publication History Article published online: 15 February 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".