Loss of Consciousness: Can There Be Unexpected Otolaryngology Etiology.
Thirty-four-years old male, soldier by
occupation had
complains of three episodes of
loss of consciousness lasting
for 3-4 seconds for last one
year. There was no
history of giddiness,
ear discharge, aural fullness,
autotoxin medication, tinnitus etc.
His examination revealed
bilateral normal tympanic membrane
and tuning fork tests
were suggestive of left sided Sensor
Neural Hearing Loss. Patient
was unaware of hearing loss.
Fistula test was negative
and caloric test demonstrated
left canal paresis. Rest
neurotological examination was normal.
Audiomertry presented left sided
moderate severe SNHL.
Cardiologist and neurologist evaluation
was normal. MRI brain was also normal.
In view of left sided ear hearing loss
and canal paresis on
caloric test, high resolution CT
temporal bone was performed
and it clinched the diagnosis of
left Superior Semicircular
Canal Dehiscence.
The patient was taken up for
surgical closure of SSCD by
middle cranial fossa approach.
The defect was closed by fat
and tissue glue. Presently, patient
is asymptomatic for two years.
The true incidence of SSCD is unknown due its rare
presentation. The etiology of
this syndrome was
localized to a dehiscence of the
bone covering the superior semicircular
canal.
The abnormal communication between the superior
semicircular canal
and the brain can
result in vertigo and oscillopsia induced by
loud sounds, by changes in
pressure in the ear canal that
are transmitted to t
he middle ear, or by Valsalva
maneuvers.
Our patient was not having any such
presentation as
described making it atypical.
Our case of young adult soldier with
episodes of loss of
consciousness with unilateral SNHL is
being reported to emphasize on complete
neurotological
examination and thorough workup on
such patients as diseases can have unusual presentation.
Otolaryngol Open J. 2016; 2(4): 109-110. doi: 10.17140/OTLOJ-2-124