上半規管裂隙症候群：個案研究

Superior Semicircular Canal Dehiscence Syndrome: Case Study

10.6143/JSLHAT.202106_(44).0005

吳蕙君(Huei-Jun Wu)；王懋哲(Mao-Che Wang)

上半規管裂隙症候群 ； 第三窗 ； 前庭誘發肌電位 ； Superior semicircular canal dehiscence syndrome ； Third mobile window ； Vestibular evoked myogenic potential

台灣聽力語言學會雜誌

44期（2021 / 06 / 01）

87 - 95

繁體中文

「上半規管裂隙症候群」自1998年被Minor、Solomon、Zinreich與Zee提出。臨床診斷指引包括：高解析電腦斷層有上半規管裂隙、骨聽敏感或響音誘發眩暈或脈動耳鳴等症狀至少一項、診斷工具顯示第三窗異常壓力傳導。本研究探討「上半規管裂隙症候群」的檢查及診斷相關性。研究個案為王女士，56歲，因雙耳耳鳴、先前感冒就醫。檢測結果為左耳混合性聽力損失，右耳感音神經性聽力損失，電腦斷層顯示左側上半規管裂隙，右側管壁較薄，前庭誘發頸肌電位呈現雙側閾值降低。耳鳴眩暈患者如果鼓室圖正常，但出現混合性聽力損失，前庭誘發肌電位可提供生理學相關及輔助性的診斷角色。本個案符合臨床診斷指引。

Superior semicircular canal dehiscence syndrome (SCDS) was first reported by Minor, Solomon, Zinreich, and Zee in 1998. Proposed diagnostic criteria should meet three conditions. First of all, high resolution computed tomography (HRCT) need to demonstrate a dehiscence in the superior semicircular canal (SSC). Secondly, the symptoms show bone conduction hyperacusis, sound and/or pressure-induced vertigo or pulsatile tinnitus. Finally, the diagnostic tests indicating third mobile window. The study aims to discuss the evaluation and diagnosis of SCDS. A 56 years old female, went to our hospital for her tinnitus and previous cold. The hearing test shows normal tympanogram, moderate mixed type hearing loss in the left ear, and sensorineural hearing loss in the right ear. HRCT demonstrate a fissure in the left SSC. Cervical-vestibular evoked myogenic potential (cVEMP) show bilateral thresholds reduced and the patient undergo sound-induced vertigo during the test. It was found that the HRCT did show a marked upper semicircular canal fissure on the left side and a thinner wall on the right side. In patients with tinnitus and vertigo, if the tympanogram is normal, but mixed type hearing loss occurs, in addition to HRCT, VEMP can also provide physiologically relevant roles in the diagnosis of SCDS. This case complies with the clinical diagnosis guidelines.

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