Postpartum Vertigo and Superior Semicircular Canal Dehiscence Syndrome

Department of Obstetrics and Gynecology, Washington University in St. Louis, San Luis, Missouri, United States
Obstetrics and Gynecology (Impact Factor: 5.18). 09/2009; 114(2 Pt 2):434-6. DOI: 10.1097/AOG.0b013e3181ae8da0
Source: PubMed


Superior semicircular canal dehiscence is a recently described cause of imbalance, hearing loss, and tinnitus. Symptoms may begin after abrupt changes in intracranial or middle ear pressure.
This patient presented with a 6-year history of imbalance, hearing loss, and pulsatile tinnitus beginning when she was pushing during labor. A temporal-bone computed tomography scan showed a dehiscence of the superior semicircular canal. Surgical repair of the dehiscence through the middle cranial fossa resulted in immediate resolution of the patient's symptoms, and she returned to full activity within 3 weeks.
Superior semicircular canal dehiscence is recognized increasingly as a cause of multiple otologic symptoms. Obstetricians and gynecologists with patients complaining about postpartum vertigo should inquire about symptom onset and focus their questions around events during the second stage of labor. Patients with symptoms of dehiscence should be referred to a neurootologist for treatment, including possible surgical repair.

Full-text preview

Available from:
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aetiology of the superior semicircular canal dehiscence is currently unknown. Our objective was to analyse and discuss different hypotheses about the origin of this pathology. In this study performed on 295 temporal bones, one case of partial alteration of the bony roof in the right superior semicircular canal was described from the anatomical and radiological points of view, and compared with the temporal bone on the other side. Macroscopically, the superior semicircular canal shows deterioration in the bony roof, which consists exclusively of the inner or endosteal layer that separates the canal from the superior semicircular conduct. The Pöschl plane reconstruction showed a whole bony roof, but its thickness decreased from the canal curvature to the defect (from 0.6 to 0.3mm). The presence of partial defects in the bony roof of the superior semicircular canal with absence of the external and middle layers, besides its lesser thickness, makes the canal susceptible to suffering a second event. This could produce its fracture and a dehiscence.
    No preview · Article · Feb 2011 · Acta Otorrinolaringológica Española
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this clinical review is to highlight the otolaryngological symptoms that occur in pregnancy. Where available, the authors discuss the current evidence of the etiology and management of the various presentations. While it is appreciated that many of these complaints are transient, their impact on the maternal quality of life can be significant, and therefore, medical practitioners should be aware of what to expect in order to provide reassurance to patients and also to safely manage such symptoms. MEDLINE and EMBASE databases were searched for publications related to otolaryngology and pregnancy. All literature was searched for and reviewed by 2 authors independently. Search results were then cross-examined, and any differences were settled by consensus. Pregnancy leads to circulatory changes and increased susceptibility to viral reactivation, and along with the exertion of parturition, it can lead to tinnitus, facial palsies, and deafness. Rising levels of sex hormones and heightened sensitivity to allergens may influence the nasal mucosa, precipitating epistaxis and rhinitis. Increased progesterone and the increased intra-abdominal pressure of the growing fetus can lead to symptoms and sequelae of laryngopharyngeal reflux. Evidence for the treatment of pregnancy-induced symptoms is principally restricted to case reports and retrospective studies. Recognition and understanding of pregnancy-related ear, nose, and throat complaints will allow otolaryngologists to reassure and manage these patients, improving their experience of the gestational period. High-quality evidence for their management is limited, with further research required.
    Preview · Article · May 2011 · Otolaryngology Head and Neck Surgery

  • No preview · Article · Sep 2011 · Journal of the American Dietetic Association
Show more