The treatment of superior semicircular canal dehiscence: A review of the literature about a not completely clarified problem

Objective: This paper reviews the principal surgical strategies proposed in the literature in approaching the Superior Semicircular Canal Dehiscence (SSCD) syndrome. It examines the controversies regarding each treatment modality including surgical indications, procedures and the main outcomes. Design: A systematic literature research was conducted using a number of resources including electronic databases, books and websites. Relevant citations from current publications were also followed up. Results: Two principal types of surgical procedure for the treatment of superior canal dehiscence were identified: canal plugging and resurfacing. Each can be performed by both a middle cranial fossa (MCF) and transmastoid (TM) approach. An alternative and less invasive option to treat this pathological condition, without repairing the underlying lesion, has recently emerged from the literature: the round window (RW) niche reinforcement through a transmeatal approach. Conclusions: All the reported techniques represent reliable and effective solutions in cases of intolerable symptoms; nevertheless, the controversies still present about the pathophysiological changes linked to dehiscence reflect the difficulties in proposing a universal method of treatment. It is, therefore, probable that a more prolonged knowledge of this affection is necessary to fully understand all its implications. © 2014 Informa Healthcare.