Superior Semicircular Canal Dehiscence (SSCD) is a recently-defined developmental defect may be associated with several craniofacial anomalies such as Cleft Lip/Palate (CLP). The present study aimed to compare subjects with unilateral and bilateral CLP and normal controls in terms of Superior Semicircular Canal (SSC) bone thickness and pattern.
Subjects and Methods
A total of 238 Cone Beam Computed Tomography (CBCT) images were collected from 52 unilateral Cleft Lip and Palate (UCLP) subjects (104 temporal bones) and 38 Bilateral Cleft Lip and Palate (BCLP) (76 temporal bones) subjects and 148 healthy controls (296 temporal bones). The SSC bone thickness was measured twice and validated by a maxillofacial radiologist. The samples were then classified into five categories based on bone thickness: papyraceous or thin, normal, thick, pneumatized, and dehiscence. After all, the UCLP, BCLP, and normal control groups were compared concerning the SSC pattern and thickness.
Results
The results revealed no significant difference among the three groups regarding the SSC pattern and thickness based on gender. The SSC patterns (P value = .001) and SSC thickness (0.01) were strongly correlated to the cleft type. The thinnest bone thickness and the highest incidence of SSCD were observed among the subjects with BCLP.
Conclusions
The results showed a significant association between the SSC patterns and SSC thickness and the study groups.
KhanMIPrashanthC. Case–parent trio studies in cleft lip and palate. Global Med Genet. 2020;7(03):075-079.
2.
GómezOPuertoB. Cleft lip and palate. In: Obstetric imaging: fetal diagnosis and care. Elsevier; 2018:311-316. e1.
3.
KucukguvenACalisMTopalogluHOzgurF. Assessment of neurologic disorders and rare intracranial anomalies associated with cleft lip and palate. J Craniofac Surg. 2018;29(8):2195-2197.
4.
SekhonPEthunandanMMarkusAKrishnanGRaoCB. Congenital anomalies associated with cleft lip and palate—an analysis of 1623 consecutive patients. J Cleft Palate-Craniofac J. 2011;48(4):371-378.
5.
AzzaldeenANezarWMuhamadA-H. Congenital anomalies associated with cleft lip and palate. IOSR J Dent Med Sci (IOSR-JDMS). 2018;17(1):30-38.
6.
CalzolariEPieriniAAstolfiGBianchiFNevilleAJRivieriF. Associated anomalies in multi-malformed infants with cleft lip and palate: an epidemiologic study of nearly 6 million births in 23 EUROCAT registries. J Am J Med Genet A. 2007;143A(6):528-537.
7.
MinorLBSolomonDZinreichJSZeeDS. Sound-and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol–Head Neck Surg. 1998;124(3):249-258.
8.
GianoliGJSoileauJ. Pathophysiology and diagnosis of superior canal dehiscence. In: BabuSSchuttCABojrabDI, eds. Diagnosis and treatment of vestibular disorders. Springer International Publishing; 2019:215-227.
9.
CeylanNBayraktarogluSAlperH, et al.CT Imaging of superior semicircular canal dehiscence: added value of reformatted images. Acta Otolaryngol.2010;130(9):996-1001.
10.
MinorLB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope.2005;115(10):1717-1727.
11.
MondinaMBonnardDBarreauXDarrouzetVFranco-VidalV. Anatomo-radiological study of the superior semicircular canal dehiscence of 37 cadaver temporal bones. Surg Radiol Anat. 2013;35(1):55-59.
12.
SequeiraSMWhitingBRShimonyJSVoKDHullarTE. Accuracy of computed tomography detection of superior canal dehiscence. Otol Neurotol. 2011;32(9):1500-1505.
13.
ManaraRLionelloMde FilippisCCittonVStaffieriAMarioniG. Superior semicircular canal dehiscence: A possible pathway for intracranial spread of infection. Am J Otolaryngol.2012;33(2):263-265. doi:10.1016/j.amjoto.2011.05.006.
14.
StarbuckJMGhoneimaAKulaK. Bilateral cleft lip and palate: a morphometric analysis of facial skeletal form using cone beam computed tomography. Clin Anat.2015;28(5):584-592.
15.
StarbuckJMGhoneimaAKulaK. A multivariate analysis of unilateral cleft lip and palate facial skeletal morphology. J Craniofac Surg. 2015;26(5):1673-1678.
16.
SadlerTW. Langman’s Medical Embryology. Lippincott Williams and Wilkins; 2011.
17.
HussainABangashWUKhanMIAliMAKhanAIbrahimM. Frequency of otitis media with effusion in cleft palate children. Gomal J Med Sci. 2019;17(2):52-55.
18.
MirashrafiFSaediBRabbaniMGarmaroudiGToosiRAbouhamzehK. Evaluating the frequency of ear problems in patients with cleft lip and palate. J Iran Med Counc. 2021;4(1):49-54.
19.
CisnerosAIWhyteJMartínezC, et al.Radiological patterns of the bony roof of the superior semicircular canal. Surg Radiol Anat. 2013;35(1):61-65.
20.
CisnerosAIWhyteJMartínezC, et al.Radiological patterns of the posterior semicircular canal. Surg Radiol Anat. 2014;36(2):137-140.
21.
CloutierJ-FBélairMSalibaI. Superior semicircular canal dehiscence: positive predictive value of high-resolution CT scanning. Eur Arch Oto-Rhino-Laryngol.2008;265(12):1455-1460.
22.
TavassolieTSPenningerRTZuñigaMGMinorLBCareyJP. Multislice computed tomography in the diagnosis of superior canal dehiscence: how much error, and how to minimize it?Otol Neurotol.2012;33(2):215-222.
23.
MasakiY. The prevalence of superior canal dehiscence syndrome as assessed by temporal bone computed tomography imaging. Acta Otolaryngol.2011;131(3):258-262. doi:10.3109/00016489.2010.526145.
24.
SepúlvedaISchmidtTPlatínPlatínE. Use of cone beam computed tomography in the diagnosis of superior semicircular canal dehiscence. J Clin Imaging Sci. 2014;4(3):1-4.
25.
ChoYWShimBSKimJW, et al.Prevalence of radiologic superior canal dehiscence in normal ears and ears with chronic otitis media. Laryngoscope.2014;124(3):746-750.
26.
ZhouGGopenQPoeDS. Clinical and diagnostic characterization of canal dehiscence syndrome: a great otologic mimicker. Otology Neurotology. 2007;28(7):920-926.
27.
TeixidoMTArtzGJKungBC. Clinical experience with symptomatic superior canal dehiscence in a single neurotologic practice. Otolaryngol Head Neck Surg. 2008;139(3):405-413. doi:10.1016/j.otohns.2008.06.023.
28.
DumanISDoganSN. Contribution of reformatted multislice temporal computed tomography images in the planes of stenvers and pöschl to the diagnosis of superior semicircular canal dehiscence. J Comput Assist Tomogr.2020;44(1):53-58.
29.
MauCKamalNBadetiS, et al.Superior semicircular canal dehiscence: diagnosis and management. J Clin Neurosci.2018;48:58-65.
30.
LookabaughSNiestenMEOwocMKozinEDGrolmanWLeeDJ. Audiologic, cVEMP, and radiologic progression in superior canal dehiscence syndrome. JAMA Otolaryngol Head Neurotol. 2016;37(9):1393-1398.
31.
NiestenMELookabaughSCurtinH, et al.Familial superior canal dehiscence syndrome. JAMA Otolaryngol Head Neck Surg. 2014;140(4):363-368.
32.
PatelNSHunterJBO'ConnellBPBertrandNMWannaGBCarlsonML. Risk of progressive hearing loss in untreated superior semicircular canal dehiscence. Laryngoscope.2017;127(5):1181-1186.
33.
AltunODumanSBBayrakdarISYasaYDumanSGünen YılmazS. Cone beam computed tomography imaging of superior semicircular canal morphology: a retrospective comparison of cleft lip/palate patients and normal controls. Acta Odontol Scand.2018;76(4):247-252.
34.
EvliceBÇabukDSDuyanH. The evaluation of superior semicircular canal bone thickness and radiological patterns in relation to age and gender. Surg Radiol Anat.2021;43(11):1839-1844. doi:10.1007/s00276-021-02797-4.
35.
KaurTJohanisMMiaoT, et al.CT Evaluation of normal bone thickness overlying the superior semicircular canal. J Clin Neurosci.2019;66:128-132. doi:10.1016/j.jocn.2019.05.001.
36.
MahuluENFanXDingS, et al.The variation of superior semicircular canal bone thickness in relation to age and gender. Acta Otolaryngol.2019;139(6):473-478.
37.
NguyenTSheppardJPDuongC, et al.Age and gender considerations on the symptomology in patients with superior semicircular canal dehiscence: a systematic review and case illustration. J Clin Neurosci.2019;65:112-120. doi:10.1016/j.jocn.2019.04.006.
38.
CrovettoMWhyteJRodriguezOMLecumberriIMartinezCEléxpuruJ. Anatomo-radiological study of the superior semicircular canal dehiscence: radiological considerations of superior and posterior semicircular canals. Eur J Radiol.2010;76(2):167-172. doi:10.1016/j.ejrad.2009.05.038.
39.
KarimnejadKCzernyMSLookabaughSLeeDJMikulecAA. Gender and laterality in semicircular canal dehiscence syndrome. J Laryngol Otol. 2016;130(8):712-716. doi:10.1017/S0022215116008185.
40.
AllenKPPerezCLIsaacsonBRolandPSDuongTTKutzJW. Superior semicircular canal dehiscence in patients with spontaneous cerebrospinal fluid otorrhea. Otolaryngol Head Neck Surg. 2012;147(6):1120-1124. doi:10.1177/0194599812457545.
41.
StimmerHHamannKFZeiterSNaumannARummenyEJ. Semicircular canal dehiscence in HR multislice computed tomography: distribution, frequency, and clinical relevance. Eur Arch Oto-Rhino-Laryngol.2012;269(2):475-480. doi:10.1007/s00405-011-1688-6.
42.
KurtHOrhanKAksoySKursunSAkbulutNBilecenogluB. Evaluation of the superior semicircular canal morphology using cone beam computed tomography: a possible correlation for temporomandibular joint symptoms. Oral Surg Oral Med Oral Pathol Oral Radiol.2014;117(3):e280-e288. doi:10.1016/j.oooo.2014.01.011.
43.
SaxbyAJGowdyCFandiñoM, et al.Radiological prevalence of superior and posterior semicircular canal dehiscence in children. Int J Pediatr Otorhinolaryngol.2015;79(3):411-418. doi:10.1016/j.ijporl.2015.01.001.
44.
AkayGKarataşMSKaradağÖÜçokCÖGüngörK. Examination of the possible relation of the superior semicircular canal morphology with the roof thickness of the glenoid fossa and bone changes of the temporomandibular joint. Eur Arch Oto-Rhino-Laryngol.2020;277(12):3423-3430. doi:10.1007/s00405-020-06063-y.
45.
WilliamsonRAVrabecJTCokerNJSandlinM. Coronal computed tomography prevalence of superior semicircular canal dehiscence. Otolaryngol Head Neck Surg. 2003;129(5):481-489. doi:10.1016/S0194-59980301391-3.
46.
BerningAAraniKBranstetterB. Prevalence of superior semicircular canal dehiscence on high-resolution CT imaging in patients without vestibular or auditory abnormalities. Am J Neuroradiol. 2019;40(4):709-712.
47.
NoijKSRauchSD. Vestibular evoked myogenic potential (VEMP) testing for diagnosis of superior semicircular canal dehiscence. Front Neurol.2020;11:695.
48.
ScarfeWCLevinMDGaneDFarmanAG. Use of cone beam computed tomography in endodontics. Int J Dent. 2009;2009:634567. doi:10.1155/2009/634567.
49.
GrunzJ-PWengAMGietzenCH, et al.Evaluation of ultra-high-resolution cone-beam CT prototype of twin robotic radiography system for cadaveric wrist imaging. Acad Radiol.2021;28(10):e314-e322.
50.
PaknahadMShahidiS. Association between mandibular condylar position and clinical dysfunction index. J Cranio-Maxillofac Surg. 2015;43(4):432-436. doi:10.1016/j.jcms.2015.01.005.
51.
PaknahadMShahidiSZareiZ. Sexual dimorphism of maxillary sinus dimensions using cone-beam computed tomography. J Forensic Sci.2017;62(2):395-398.
52.
BremkeMLuersJ-CAnagiotosA, et al.Comparison of digital volume tomography and high-resolution computed tomography in detecting superior semicircular canal dehiscence–a temporal bone study. Acta Otolaryngol.2015;135(9):901-906.
53.
KuoC-LLienC-FChuC-HShiaoA-S. Otitis media with effusion in children with cleft lip and palate: a narrative review. Int J Pediatr Otorhinolaryngol.2013;77(9):1403-1409. doi:10.1016/j.ijporl.2013.07.015.
54.
SugiharaEMBabuSCKitskoDJHaupertMSThottamPJ. Incidence of pediatric superior semicircular canal dehiscence and inner ear anomalies: a large multicenter review. J Otol Neurotol. 2016;37(9):1370-1375.
55.
GoldbergERoedigerDKucukboyaciNE, et al.Hemispheric asymmetries of cortical volume in the human brain. J Cortex. 2013;49(1):200-210.
