Rapid, uncontrollable eye movements that swish and thump as the eyes roll and blink. Bones that creak as the body moves. Sudden dizziness, loss of balance. Falling down after a loud noise, such as the sound of your own voice, a cough or even laughter. These are hallmarks of a debilitating and relatively rare syndrome known as superior canal dehiscence that has stumped clinicians for a long time.
Victims lose balance, fall down stairs, are unable to read or sleep due to loud noises inside their head, and some become convinced they are mentally ill, suffering from symptoms that won't yield to conventional treatment. Now, Johns Hopkins surgeons have proven that these symptoms can all be successfully treated by a single operation that plugs up a threadbare layer of bone in the inner ear.
Superior canal dehiscence occurs in roughly equal numbers of men and women and is often not diagnosed until after age 40, when symptoms, such as hearing loss, appear to worsen. However, patients often recall that initial symptoms happened much earlier in their lives.
"The surgical plugging procedure can put a stop to even severe symptoms and can lead to a return to normal daily activities and, in some cases, to a mild-to-moderate improvement in hearing," says Lloyd B. Minor, M.D., the Andelot Professor and director of otolaryngology - head and neck surgery at The Johns Hopkins University School of Medicine. It was Minor who, in 1998, first clinically described superior canal dehiscence and developed the surgical techniques to repair it.
In a pair of reports believed to offer the largest followup analysis of patients after their surgery for the syndrome, a Hopkins team, led by Minor, found that plugging the superior canal where the bone casing is thin
Contact: David March
Johns Hopkins Medical Institutions