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Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence


Merchant, Gabrielle R; Röösli, Christof; Niesten, Marlien E F; Hamade, Mohamad A; Lee, Daniel J; McKinnon, Melissa L; Ulku, Cagatay H; Rosowski, John J; Merchant, Saumil N; Nakajima, Hideko Heidi (2015). Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. Otology & Neurotology, 36(1):172-177.

Abstract

HYPOTHESIS: Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis.
BACKGROUND: The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions).
METHODS: Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations).
RESULTS: Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%.
CONCLUSION: This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.

Abstract

HYPOTHESIS: Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis.
BACKGROUND: The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions).
METHODS: Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations).
RESULTS: Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%.
CONCLUSION: This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:January 2015
Deposited On:27 Feb 2015 09:27
Last Modified:07 Aug 2017 07:02
Publisher:Lippincott Williams & Wilkins
ISSN:1531-7129
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1097/MAO.0000000000000294
PubMed ID:25076227

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