{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:07:55Z","timestamp":1785298075535,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate cochleovestibular outcomes following trans\u2010mastoid superior semicircular canal (SSC) occlusion in patients with symptomatic superior semicircular canal dehiscence (SSCD) and third\u2010window syndrome (TWS), and to characterize objective pre\u2014and postoperative functional changes in a tertiary\u2010center cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of patients undergoing trans\u2010mastoid SSC occlusion for SSCD with TWS were retrospectively reviewed. Diagnosis was based on characteristic cochleovestibular symptoms, physical examination, and imaging findings. Standardized pre\u2010 and postoperative assessments included pure\u2010tone audiometry, videonystagmography (VNG), ocular vestibular evoked myogenic potentials (oVEMP), video head impulse testing (vHIT), and electrocochleography (EcochG). Surgery was performed through a postauricular trans\u2010mastoid approach with SSC plugging using autogenous periosteum reinforced with temporalis fascia, bone p\u00e2t\u00e9, and fibrin sealant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty patients underwent surgery. Preoperative symptoms included hearing loss (95%), autophony (85%), and Tullio phenomenon (70%). Mean preoperative 500\u2010Hz air\u2010bone gap was 25\u2009\u00b1\u20098.7\u2009dB. Affected ears demonstrated significantly reduced oVEMP thresholds (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and elevated EcochG SP\/AP ratios compared with contralateral ears (0.212\u2009\u00b1\u20090.086 vs. 0.275\u2009\u00b1\u20090.071,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Following surgery, all patients reported symptomatic improvement with complete resolution of Tullio phenomenon. Mean air\u2010bone gap improved to 4.3\u2009\u00b1\u20096.1\u2009dB with preserved speech recognition. SP\/AP ratios normalized postoperatively and were comparable between ears (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.062). oVEMP thresholds normalized compared to contralateral ears. vHIT demonstrated reduced gain in the operated canal (0.49\u2009\u00b1\u20090.18 vs. 0.84\u2009\u00b1\u20090.05,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while caloric responses remained unchanged.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Trans\u2010mastoid SSC occlusion provides effective symptom relief with favorable cochleovestibular outcomes in SSCD with TWS. Objective testing demonstrates restoration of third\u2010window physiology while preserving hearing and overall vestibular function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70775","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:53:01Z","timestamp":1785297181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cochleovestibular Function of Trans\u2010Mastoid Occlusion for Superior Semicircular Canal Dehiscence"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5904-1291","authenticated-orcid":false,"given":"Omer J.","family":"Ungar","sequence":"first","affiliation":[{"name":"Division of Otology\/Neurotology, Department of Otolaryngology\u2010Head and Neck Surgery Toronto General Hospital, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4284-9793","authenticated-orcid":false,"given":"Ross","family":"O'Shea","sequence":"additional","affiliation":[{"name":"Division of Otology\/Neurotology, Department of Otolaryngology\u2010Head and Neck Surgery Toronto General Hospital, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2358-9738","authenticated-orcid":false,"given":"Fatemeh","family":"Hassannia","sequence":"additional","affiliation":[{"name":"Division of Otology\/Neurotology, Department of Otolaryngology\u2010Head and Neck Surgery Toronto General Hospital, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Rutka","sequence":"additional","affiliation":[{"name":"Division of Otology\/Neurotology, Department of Otolaryngology\u2010Head and Neck Surgery Toronto General Hospital, University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1001\/archotol.124.3.249","article-title":"Sound\u2010 and\/or Pressure Induced Vertigo due to Bone Dehiscence of the Superior Semicircular Canal","volume":"124","author":"Minor L. B.","year":"1998","journal-title":"Archives of Otolaryngology \u2013 Head & Neck Surgery"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","DOI":"10.1097\/01.mlg.0000178324.55729.b7","article-title":"Clinical Manifestations of Superior Semicircular Canal Dehiscence","volume":"115","author":"Minor L. B.","year":"2005","journal-title":"Laryngoscope"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.amjoto.2019.102287","article-title":"Quality of Life Outcomes After Transmastoid Plugging of Superior Semicircular Canal Dehiscence","volume":"41","author":"Allsopp T.","year":"2020","journal-title":"American Journal of Otolaryngology"},{"issue":"10","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1097\/MAO.0000000000000886","article-title":"Health Utility Improves After Surgery for Superior Canal Dehiscence Syndrome","volume":"36","author":"Remenschneider A. K.","year":"2015","journal-title":"Otology & Neurotology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.552495","article-title":"Impact of Superior Canal Dehiscence Syndrome on Health Utility Values: A Prospective Case\u2010Control Study","volume":"11","author":"Ocak I.","year":"2020","journal-title":"Frontiers in Neurology"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00405-013-2497-x","article-title":"Dehiscence of the Superior Semicircular Canal: A Review of the Literature on Its Possible Pathogenic Explanations","volume":"271","author":"Brandolini C.","year":"2014","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_10_8_1","article-title":"Effect on Brainstem Auditory Evoked Responses of Posterior Semicircular Canal Occlusion in Guinea Pigs","volume":"14","author":"Parnes L. 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W.","year":"1962","journal-title":"ORL; Journal for Oto\u2010Rhino\u2010Laryngology and Its Related Specialties"},{"issue":"10","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"4861","DOI":"10.1007\/s00405-022-07316-8","article-title":"Evaluation of the Transmastoid Plugging Approach for Superior Semicircular Canal Dehiscences: A Retrospective Series of 30 Ears","volume":"279","author":"Gersdorff G.","year":"2022","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"3","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1177\/0194599817751092","article-title":"Effectiveness of Transmastoid Plugging for Semicircular Canal Dehiscence Syndrome","volume":"158","author":"Banakis Hartl R. 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M.","year":"2016","journal-title":"Laryngoscope"},{"issue":"8","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1097\/MAO.0000000000001114","article-title":"An Easy and Reliable Method to Locate the Dehiscence During Middle Fossa Superior Canal Dehiscence Surgery: It Is a (c) Inch","volume":"37","author":"Patel N. S.","year":"2016","journal-title":"Otology & Neurotology"},{"issue":"4","key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1007\/s00405-024-09067-0","article-title":"Arcuate Eminence Distance to Temporal Bone Outer Table in the Middle Fossa Repair of Superior Canal Dehiscence","volume":"282","author":"Yang H. H.","year":"2025","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"4","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1055\/s-0037-1601886","article-title":"A Method of Locating the Dehiscence During Middle Fossa Approach for Superior Semicircular Canal Dehiscence Surgery","volume":"78","author":"Beckett J. S.","year":"2017","journal-title":"Journal of Neurological Surgery, Part B, Skull Base"},{"issue":"2","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1055\/s-0039-1683432","article-title":"Euclidean Relationship Between the Superior Semicircular Canal and the Arcuate Eminence","volume":"81","author":"Nourbakhsh A.","year":"2020","journal-title":"Journal of Neurological Surgery Part B: Skull Base"},{"issue":"12","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"E904","DOI":"10.1002\/lary.28490","article-title":"Tegmen Attenuation in Patients With Idiopathic Intracranial Hypertension Is Progressive","volume":"130","author":"Handzel O.","year":"2020","journal-title":"Laryngoscope"},{"issue":"6","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/MAO.0000000000001814","article-title":"Clinical Implications of the Association Between Temporal Bone Tegmen Defects and Superior Semicircular Canal Dehiscence","volume":"39","author":"Handzel O.","year":"2018","journal-title":"Otology & Neurotology"},{"issue":"5","key":"e_1_2_10_31_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.amjoto.2024.104411","article-title":"An Algorithm for the Surgical Approach to Spontaneous Temporal Bone CSF Leak","volume":"45","author":"Handzel O.","year":"2024","journal-title":"American Journal of Otolaryngology"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2023.1125951","article-title":"Factors Affecting Variability in Vestibulo\u2010Ocular Reflex Gain in the Video Head Impulse Test in Individuals Without Vestibulopathy: A Systematic Review of Literature","volume":"14","author":"Money\u2010Nolan L. E.","year":"2023","journal-title":"Frontiers in Neurology"},{"issue":"2","key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.1097\/MAO.0000000000001665","article-title":"Intra\u2010And Interexaminer Variability of Two Separate Video Head Impulse Test Systems Assessing All Six Semicircular Canals","volume":"39","author":"Abrahamsen E. R.","year":"2018","journal-title":"Otology & Neurotology"},{"issue":"3","key":"e_1_2_10_34_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/01.mao.0000253284.40995.d8","article-title":"Semicircular Canal Function Before and After Surgery for Superior Canal Dehiscence","volume":"28","author":"Carey J. P.","year":"2007","journal-title":"Otology & Neurotology"},{"issue":"10","key":"e_1_2_10_35_1","doi-asserted-by":"crossref","first-page":"5229","DOI":"10.1007\/s00415-021-10693-5","article-title":"The Resilience of the Inner Ear\u2014Vestibular and Audiometric Impact of Transmastoid Semicircular Canal Plugging","volume":"269","author":"Stultiens J. J.","year":"2022","journal-title":"Journal of Neurology"},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.00694","article-title":"Changes in Vestibulo\u2010Ocular Reflex Gain After Surgical Plugging of Superior Semicircular Canal Dehiscence","volume":"11","author":"Lee S. Y.","year":"2020","journal-title":"Frontiers in Neurology"},{"issue":"2","key":"e_1_2_10_37_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/00016489.2025.2449593","article-title":"Transmastoid Superior Semicircular Canal Dehiscence Plugging: VHIT Findings","volume":"146","author":"Benoit C.","year":"2026","journal-title":"Acta Oto\u2010Laryngologica"},{"issue":"3","key":"e_1_2_10_38_1","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1007\/s00106-024-01533-9","article-title":"Superior Semicircular Canal Dehiscence Isolation by Transmastoid Two\u2010Point Canal Plugging With Preservation of the Vestibulo\u2010Ocular Reflex","volume":"73","author":"Seiwerth I.","year":"2025","journal-title":"HNO"},{"key":"e_1_2_10_39_1","first-page":"1","article-title":"Anatomy, Physiology, and Physics of the Peripheral Vestibular System","volume":"137","author":"Kingma H.","year":"2016","journal-title":"Handbook of Clinical Neurology"},{"key":"e_1_2_10_40_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1055\/s-0037-1599785","article-title":"Superior Semicircular Canal Dehiscence Syndrome\u2014diagnosis and Surgical Management","volume":"21","author":"Palma Diaz M.","year":"2017","journal-title":"International Archives of Otorhinolaryngology"},{"key":"e_1_2_10_41_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2017.00177","article-title":"Superior Canal Dehiscence Syndrome: Lessons From the First 20\u2009Years","volume":"8","author":"Ward B. 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Review of the Literature and Our Institutional Experience","volume":"5","author":"Ishai R.","year":"2017","journal-title":"Current Otorhinolaryngology Reports"},{"issue":"4","key":"e_1_2_10_44_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.amjoto.2013.01.009","article-title":"Quantification of Hearing Loss Associated With Superior Semi\u2010Circular Canal Dehiscence","volume":"34","author":"McEvoy T. P.","year":"2013","journal-title":"American Journal of Otolaryngology"},{"issue":"3","key":"e_1_2_10_45_1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/01.mlg.0000157844.48036.e7","article-title":"Operative Management of Superior Semicircular Canal Dehiscence","volume":"115","author":"Mikulec A. A.","year":"2005","journal-title":"Laryngoscope"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70775","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70775","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:53:07Z","timestamp":1785297187000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":44,"alternative-id":["10.1002\/lary.70775"],"URL":"https:\/\/doi.org\/10.1002\/lary.70775","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70775"}}