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

11 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 - Hamade, Mohamad A.

AU - Lee, Daniel J.

AU - McKinnon, Melissa L.

AU - Ulku, Cagatay H.

AU - Rosowski, John J.

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AU - Nakajima, Hideko Heidi

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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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