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Interest in Superior Semicircular Canal Dehiscence (SSCD) has increased, but its diagnosis and management remain challenging. Despite advances in imaging and electrophysiological tests, many patients face long diagnostic delays and significant distress due to unclear symptom severity. While some patients show no symptoms despite radiological evidence, others experience disabling effects. This research aims to bridge the gap between objective tests and symptom severity, improving the understanding and management of SSCD. This is a prospective, non-randomized, longitudinal observational clinical study including repeated measures. It is part of the inter-regional hospital research program \"INTEX-DEHI\", involving five university hospitals. Patients diagnosed with unilateral superior semicircular canal dehiscence via CT scan will be followed over four weeks with three visits spaced 15 days apart. The main objective is to describe the clinical and paraclinical characteristics of SSCD and analyze their correlation. Electrophysiological, functional, and clinical measurements will be collected at each visit. The relationship between electrophysiological tests and the symptomatic impact of superior semicircular canal dehiscence remains underexplored. This research aims to bridge this gap by studying both common and specific VEMP frequencies, as well as EcoG and WBT, to assess their sensitivity, specificity, and diagnostic value. While this study proposes innovative tools to objectively assess symptoms, challenges remain, particularly the underdiagnosis of the syndrome and selection biases, especially in patients with fluctuating symptoms. Additionally, the diversity of clinical presentations and the absence of symptoms in some patients complicate the interpretation of results. Clinicaltrials.gov, NCT06170398.

Objective This study investigates the importance of bone density, surface area, and diameter of anatomical structures of the superior semicircular canal (SSC), lateral semicircular canal (LSC), posterior semicircular canal (PSC), utricle, and saccule in patients diagnosed with superior semicircular canal dehiscence (SSCD). Materials and methods The bone density, surface area, and diameter of SSC, LSC, PSC, utricle, and saccule were measured and compared between the SSCD group and control group. Fifteen ears in the SSCD group and 60 ears in the control group were evaluated. Additionally, within the SSCD group, the dehiscent and healthy sides were evaluated independently. Results SSC’s bone density was significantly lower in the SSCD group compared to the control group ( p  = 0.008). No significant differences were found in surface area and diameter between the groups ( p  > 0.05). While most of the anatomical structures showed no significant difference in bone density between dehiscent and healthy ears ( p  > 0.05), SSC bone density was significantly lower in affected ears ( p  = 0.000) in SSCD group. Conclusion Based on the data obtained in this study, bone density and anatomical structure may be useful in patients diagnosed with SSCD.

Purpose Most of Superior Semicircular Canal Dehiscence (SSCD) are located in the apical region of the SSC. However, in a small number of cases, it may be situated in the medial wall, causing the SSC to contact with the superior petrosal sinus (SPS). The aim of this study is to describe four patients with SSCD involving the superior petrosal sinus (SSCD-SPS) and to perform a review of the literature. Methods Observational retrospective study of patients diagnosed of SSCD-SPS in a tertiary referral center. A systematic review was made, identifying 7 articles in the literature. Clinical presentation, complementary test (pure-tone audiometry, PTA; vestibular evoked myogenic potential, VEMP; computed tomography, CT), therapeutic management and outcomes were reported. Results Four new cases of SSCD-SPS are reported, in three of them a transmastoid plugging was performed. 54 patients with SSCD-SPS (57 dehiscences) were reported in the literature. The most frequent symptoms were aural pressure (57.41%) and vertigo provoked by pressure/Valsalva (55.55%). Conductive hearing loss was the most common finding in PTA (47.37%). Abnormally low thresholds were observed in 59.46% of reported VEMP. Transmastoid approach was used in ten cases, middle fossa approach in four, round window reinforcement in one, and occlusion of the SPS using coils in two. Conclusions Within SSCD, we have encountered a rare subtype characterized by its medial wall location in close proximity to the SPS. This subgroup needs special consideration as it has shown its own distinct characteristics. Regarding therapeutic management, we advocate a transmastoid approach.

Introduction Superior semicircular canal dehiscence syndrome (SCDS) is a clinical syndrome that can cause instability, vertigo, fullness, tinnitus, autophony, hearing loss (HL), Tullio phenomenon, or Hennebert’s sign. Historically, surgery has been the primary treatment reported in the literature, although some medical treatments may also be proposed. This study aims to comprehensively characterize SCDS in a large series of patients from clinical, auditory, and vestibular perspectives, and explore medical alternatives to conventional surgical treatments by comparing their results and evolution. Methods A retrospective observational study was designed in a tertiary care center. Audiovestibular tests evaluated included pure-tone audiometry (PTA), VEMPs, video head impulse test (vHIT), and CT imaging. Improvement was assessed over a follow-up period of up to 6 months for seven cardinal symptoms to verify the efficacy of the proposed treatments. Results 71 subjects with SCDS and a mean age of 51.20 ± 12.22 years were included in the study. The most common symptom found in our sample was instability in 31 patients (43.66%), followed by aural fullness or tinnitus in 29 subjects (40.85%). 36 patients (43.66%) received medical treatment, with 28 of them (77.78%) showing symptom reduction. Surgical repair was indicated in five patients, with all showing symptom improvement. Statistically significant improvement ( p  < 0.05) was observed, particularly with surgical treatment and acetazolamide, in both symptoms and objective tests such as pure-tone audiometry and VEMPs. Conclusion SCDS shows significant similarities with other otic capsule dehiscences. It is essential to perform VEMPs and CT scans to complete the diagnosis, which is usually accompanied by clearly recognizable clinical criteria. Surgery for SCDS is effective, safe, and without complications. However, in cases where symptoms are mild to moderate, addressing this condition with medical treatment using diuretics such as acetazolamide has shown promising results.

Triple semicircular canal plugging is effective in controlling vertigo in patients with Meniere's disease, however, whether the rate of causing hearing loss during treatment is still not uniform. This study aimed to evaluate the effects of Triple semicircular canal plugging (TSCP) on hearing in Meniere's disease (MD) patients. Databases Reviewed were PubMed, EMBASE, Scopus, Clinical Trials, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. The study reported on the duration, follow-up time, hearing loss, and vertigo control outcomes in MD patients evaluated by TSCP. Stata 17 software was used for data analysis and assessing the risk of bias. This meta-analysis included 367 MD patients from 7 studies. TSCP efficiently alleviated vertigo with a rate of 99% (95% CI: 0.97, 1.00) and had a hearing loss rate of 22% (95% CI: 0.16, 0.28). Subgroup analysis revealed that for hearing loss, the proportion of patients with disease duration more than or less than 12 months was 14% (95% CI: 0.05, 0.26) and 24% (95% CI: 0.19, 0.29), respectively. For vertigo control, the rates were 100% (95% CI: 0.96, 1.00) and 99% (95% CI: 0.97, 1.00), respectively. For hearing loss, the follow-up time of MD patients more than or less than 24 months was 20% (95% CI: 0.07, 0.38) and 23% (95% CI: 0.18, 0.29), respectively. For vertigo control, the rates were 99% (95% CI: 0.95, 1.00) and 99% (95% CI: 0.97, 1.00), respectively. The duration of the disease and follow-up time had no significant impact on hearing loss and vertigo control rates. TSCP was efficient for vertigo control but with a risk of hearing loss. It could be used as a surgical method for hearing preservation in advanced MD patients.

Two early Late Pleistocene (~105,000- to 125,000-year-old) crania from Lingjing, Xuchang, China, exhibit a morphological mosaic with differences from and similarities to their western contemporaries. They share pan–Old World trends in encephalization and in supraorbital, neurocranial vault, and nuchal gracilization. They reflect eastern Eurasian ancestry in having low, sagittally flat, and inferiorly broad neurocrania. They share occipital (suprainiac and nuchal torus) and temporal labyrinthine (semicircular canal) morphology with the Neandertals. This morphological combination reflects Pleistocene human evolutionary patterns in general biology, as well as both regional continuity and interregional population dynamics.

The vertebrate vestibular system is crucial for balance and navigation, and the evolution of its form and function in relation to species’ lifestyle and mode of locomotion has been the focus of considerable recent study. Most research, however, has concentrated on aboveground mammals, with much less published on subterranean fauna. Here, we explored variation in anatomy and sensitivity of the semicircular canals among 91 mammal species, including both subterranean and non-subterranean representatives. Quantitative phylogenetically informed analyses showed significant widening of the canals relative to radius of curvature in subterranean species. A relative canal width above 0.166 indicates with 95% certainty that a species is subterranean. Fluid–structure interaction modelling predicted that canal widening leads to a substantial increase in canal sensitivity; a reasonably good estimation of the absolute sensitivity is possible based on the absolute internal canal width alone. In addition, phylogenetic comparative modelling and functional landscape exploration revealed repeated independent evolution of increased relative canal width and anterior canal sensitivity associated with the transition to a subterranean lifestyle, providing evidence of parallel adaptation. Our results suggest that living in dark, subterranean tunnels requires good balance and/or navigation skills which may be facilitated by more sensitive semicircular canals.

Jawed vertebrates have inner ears with three semicircular canals, the presence of which has been used as a key to understanding evolutionary relationships. Ostracoderms, the jawless stem gnathostomes, had only two canals and lacked the lateral canal 1 – 3 . Lampreys, which are modern cyclostomes, are generally thought to possess two semicircular canals whereas the hagfishes—which are also cyclostomes—have only a single canal, which used to be regarded as a more primitive trait 1 , 4 . However, recent molecular and developmental analyses have strongly supported the monophyly of cyclostomes 5 – 7 , which has left the evolutionary trajectory of the vertebrate inner ear unclear 8 . Here we show the differentiation of the otic vesicle of the lamprey Lethenteron camtschaticum and inshore hagfish Eptatretus burgeri . This is the first time, to our knowledge, that the development of the hagfish inner ear is reported. We found that canal development in the lamprey starts with two depressions—which is reminiscent of the early developmental pattern of the inner ear in modern gnathostomes. These cyclostome otic vesicles show a pattern of expression of regulatory genes, including OTX genes, that is comparable to that of gnathosomes. Although two depressions appear in the lamprey vesicle, they subsequently fuse to form a single canal that is similar to that of hagfishes. Complete separation of the depressions results in anterior and posterior canals in gnathostomes. The single depression of the vesicle in hagfishes thus appears to be a secondarily derived trait. Furthermore, the lateral canal in crown gnathostomes was acquired secondarily—not by de novo acquisition of an OTX expression domain, but by the evolution of a developmental program downstream of the OTX genes. The differentiation of the inner ear in the lamprey Lethenteron camtschaticum and hagfish Eptatretus burgeri sheds light on the evolution of the semicircular canals of jawed vertebrates.

Eight adults with severe vestibular hypofunction underwent implantation of a device that stimulates the semicircular canal branches with continuous information about the angular motion of the head. At 6 months and 1 year, most tests of posture, gait, and quality of life showed improvement. There was hearing loss in the ear with the implant in seven participants.

To evaluate the surgical management and outcomes of lateral semicircular canal fistulas (LSCFs) in patients with middle ear cholesteatoma, focusing on hearing preservation and vestibular function. A retrospective study was conducted on nine adult patients diagnosed with LSCFs secondary to cholesteatoma who underwent surgery at a tertiary referral center between 2018 and 2024. The preoperative evaluation included otoscopy, audiometry, vestibular testing (HINTS), and high-resolution CT (HRCT) of the temporal bone. Surgical techniques included canal wall up (CWU) or canal wall down (CWD) mastoidectomy, depending on the disease extent. Cholesteatoma matrix removal from the fistula was performed carefully. Fistula closure involved layered grafts of temporalis fascia, temporalis muscle, and/or gelfoam. The postoperative follow-up included audiometry and vestibular assessments. : Nine patients with LSCFs were identified (one Type III, three Type IIb, and four Type I/IIa). Five patients were found to have additional disease complications intraoperatively, including facial nerve involvement and middle fossa dehiscence. Postoperatively, hearing outcomes varied, with some patients experiencing improvement, others demonstrating stable hearing, and some exhibiting further decline, particularly in cases with extensive disease. Vestibular symptoms, including vertigo, generally resolved postoperatively, although some patients required prolonged vestibular rehabilitation. : LSCF management in cholesteatoma surgery requires a careful preoperative assessment, meticulous surgical technique, and individualized fistula closure based on the size and type. While hearing preservation remains a challenge, particularly in extensive cases, the \"underwater technique\" and layered grafting may contribute to minimizing further damage and promoting fistula closure. Vestibular rehabilitation plays a crucial role in managing postoperative balance issues. A long-term follow-up is essential to monitor for recurrence and assess both auditory and vestibular function.