Power Reflectance as a Screening Tool for the Diagnosis of Superior Semicircular Canal Dehiscence. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Merchant, Gabrielle R.; Röösli, Christof; Niesten, Marlien E.F.; Hamade, Mohamad A.; Lee, Daniel J.; McKinnon, Melissa L.; Ulku, Cagatay H.; Rosowski, John J.; Merchant, Saumil N.; Nakajima, Hideko Heidi
• Is Part Of: Otology & neurotology. Volume 36:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000000294
• Languages: English
• ISSNs: 1531-7129

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Hypothesis</title> <p>Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis.</p> </sec> <sec> <title>Background</title> <p>The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions).</p> </sec> <sec> <title>Methods</title> <p>Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations).</p> </sec> <sec> <title>Results</title> <p>Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%.</p> </sec> <sec> <title>Conclusion</title> <p>This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.</p> </sec> </abstract>