Bilateral SSCD and Hypoalbuminemia are Linked to Distinct Postoperative Outcomes: 250 Case Series

Background: Superior semicircular canal dehiscence (SSCD) is an audiovestibular disorder due to a bone defect in the middle cranial fossa. Interestingly there are a certain subset of patients who present with bilateral SSCD. Given known associations between thyroid problems, albumin imbalance, bone integrity, and auditory dysfunction, we investigated whether there was a significant difference in bilateral SSCD among these patients and whether symptom resolution post-SSCD surgery differs. Methods: A retrospective chart review was conducted for 250 cases treated with SSCD repair. Symptom resolution following middle cranial fossa craniotomy was evaluated. Fisher’s exact (p < .05) and one-tailed binomial tests assessed whether symptom improvement in patients with autoimmune or thyroid disorders exceeded chance (p > 0.5). Albumin status and bilateral SSCD relationship was assessed using a Welch’s two-sample t-test Results: Of the 250 cases, 16 had an autoimmune disorder, 57 had a thyroid pathology, and 5 had both. Within the 182 cases with neither an autoimmune disorder nor a history of thyroid, there was significant improvement in autophony (p = .001), amplification (p = .001), hyperacusis (p = .001), and vertigo (p = .01) . However, those with an autoimmune disorder only showed resolution in autophony (p = .002). Those with a history of thyroid had improvement in amplification (p = .001), hyperacusis (p = .01), and autophony (p = .01). Additionally, bilateral SSCD patients had a significantly lower mean serum albumin level (5.03 ± 0.24; n = 28 (72%), p = 0.018). Patients with a thyroid problem had significantly lower mean serum albumin level (4.26 ± .36; p = .027). When stratified by albumin status, patients with low albumin demonstrated significant improvement only in hearing loss, dizziness, and disequilibrium imbalance (all p