Dizzying Data; Demystifying Superior Semicircular Canal Dehiscence

Monday, October 13, 2025

1:00 PM - 2:00 PM EDT

Location: 237-238

Disclosure(s):

Jacqueline E. Weinstein, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Rick F. Nelson, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel Q. Sun, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Deepa J. Galaiya, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: While it has been almost 30 years since superior semicircular canal syndrome was first characterized, it still poses significant diagnostic and management challenges. The proposed session will provide an overview of the pathophysiologic mechanisms, specifically, an understanding of how a “third window” phenomenon gives rise to hyperacusis with bone conduction, sound-induced vertigo, and the characteristic “pulsatile tinnitus” that often brings these patients to our care. In addition, we will seek to highlight sensitive and specific electrophysiologic measures and ideal imaging modalities for diagnosis. Panelists will also discuss treatment, specifically decision for transmastoid vs middle cranial fossa approaches, resurfacing of the superior semicircular canal vs plugging, and how best to counsel patients on expectations following such intervention. Finally, we will discuss symptomatic overlap of SCD with vestibular migraine and “borderline” SCD. The comprehensive otolaryngologist will leave with a robust understanding of pathophysiology and diagnosis. Neurotologist attendees will have a more nuanced understanding of treatment decision-making. Salient and most recent data will be used to support all discussion.

OUTCOME OBJECTIVE 1: Describe characteristic symptoms and pathophysiologic mechanisms underlying the "third window" phenomenon in Superior Semicircular Canal Dehiscence syndrome.

OUTCOME OBJECTIVE 2: Demonstrate knowledge of appropriate electrophysiologic and radiographic modalities for determining a diagnosis of superior semicircular canal dehiscence; interpret results of these tests in the clinical context.

OUTCOME OBJECTIVE 3: Identify optimal treatment modality for patients with superior semicircular canal dehiscence
Understand advantages and disadvantages of transmastoid vs middle cranial fossa, resurfacing vs plugging approaches for repair.

BACKGROUND STATEMENT: Opportunity to expand comprehensive otolaryngologists' knowledge of objective measures for diagnosis, counseling on treatment
Engage academy membership on best methods for treatment (still a point of significant controversy)

Comprehensive Otolaryngology Track Statement :

Moderator(s)

Jacqueline E. Weinstein, MD

Fellow
University of Cincinnati
Cincinnati, OH, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

Rick F. Nelson, MD, PhD

Professor of Otolaryngology
Indiana University
Indianapolis, IN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Daniel Q. Sun, MD

Faculty
University of Cincinnati
Cincinnati, OH, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Deepa J. Galaiya, MD

Assistant Professor of Otolaryngology - Head and Neck Surgery
Johns Hopkins - Dept of OTO - HNS
Baltimore, MD, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.