Introduction

This case report presents a 45-year-old female patient diagnosed with Superior Canal Dehiscence (SCD). The patient presented with classic symptoms including autophony, sound-induced vertigo (Tullio phenomenon), and a sensation of fullness in the left ear. The diagnosis was confirmed using high-resolution CT imaging of the temporal bone.

Clinical Presentation

The patient reported a several-year history of dizziness triggered by loud noises and pressure changes. She also described hearing loss in the affected ear and an ability to hear her own eye movements. Physical examination revealed a positive Romberg test and nystagmus elicited by loud tones.

Diagnostic Findings

High-resolution CT scan demonstrated a dehiscence of the superior semicircular canal on the left side. Audiometry confirmed a low-frequency conductive hearing loss. Vestibular evoked myogenic potentials (VEMPs) showed reduced thresholds, consistent with a third window lesion.

Management and Outcomes

After failing conservative therapy, the patient underwent surgical repair via a middle cranial fossa approach. Intraoperative findings confirmed the dehiscence. The canal was resurfaced using bone wax and temporal fascia. Postoperatively, the patient experienced significant improvement in vertigo and autophony. At 6-month follow-up, symptoms remained well-controlled with no recurrence of disabling vertigo.

Discussion

This case highlights the importance of considering Superior Canal Dehiscence in patients presenting with sound- or pressure-induced vertigo. High-resolution imaging and specialized vestibular testing are essential for accurate diagnosis. Surgical intervention can provide excellent symptom relief when conservative measures fail. The keywords for this case include: superior canal dehiscence, vertigo, hearing loss, dizziness, third window syndrome.