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

Gabrielle R Merchant, Christof Roösli, Marlien E.F. Niesten, Mohamad A. Hamade, Daniel J. Lee, Melissa L. McKinnon, Cagatay H. Ulku, John J. Rosowski, Saumil N. Merchant, Hideko Heidi Nakajima

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 thirdwindow lesions such as SCD in the early stages of a diagnostic workup.

Original languageEnglish (US)
Pages (from-to)172-177
Number of pages6
JournalOtology and Neurotology
Volume36
Issue number1
StatePublished - Jan 20 2015

Fingerprint

Semicircular Canals
Ear
Conductive Hearing Loss
Power (Psychology)
Tomography
Incidence

Keywords

  • Admittance
  • Energy reflectance
  • Power reflectance
  • Reflectance
  • Superior canal dehiscence
  • Superior semicircular canal dehiscenceVWideband acoustic immittance.

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Merchant, G. R., Roösli, C., Niesten, M. E. F., Hamade, M. A., Lee, D. J., McKinnon, M. L., ... Nakajima, H. H. (2015). Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. Otology and Neurotology, 36(1), 172-177.

Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. / Merchant, Gabrielle R; Roösli, 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.

In: Otology and Neurotology, Vol. 36, No. 1, 20.01.2015, p. 172-177.

Research output: Contribution to journalArticle

Merchant, GR, Roösli, C, Niesten, MEF, Hamade, MA, Lee, DJ, McKinnon, ML, Ulku, CH, Rosowski, JJ, Merchant, SN & Nakajima, HH 2015, 'Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence', Otology and Neurotology, vol. 36, no. 1, pp. 172-177.
Merchant GR, Roösli C, Niesten MEF, Hamade MA, Lee DJ, McKinnon ML et al. Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. Otology and Neurotology. 2015 Jan 20;36(1):172-177.
Merchant, Gabrielle R ; Roösli, 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. / Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. In: Otology and Neurotology. 2015 ; Vol. 36, No. 1. pp. 172-177.
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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 thirdwindow lesions such as SCD in the early stages of a diagnostic workup.",
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AU - Lee, Daniel J.

AU - McKinnon, Melissa L.

AU - Ulku, Cagatay H.

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N2 - 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 thirdwindow lesions such as SCD in the early stages of a diagnostic workup.

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