Discussion
B-SCD is characterized by the absence of bone covering the superior
semicircular canals, leading to various auditory and vestibular
symptoms. Articles shed light on this syndrome. Pereira et al. (2020)
reported a case of B-SSCD with bilateral conductive hearing loss and
subtle vestibular symptoms5-6. Bi et al. (2017)
explored superior semicircular canal dehiscense (SSCD) syndrome in
depth, discussing its diagnosis and treatment
options7. Mercado et al. (2016) presented a case study
of SSCD syndrome, emphasizing its clinical features8.
Lee et al. (2016) discussed a case of bilateral SSCD with the Tullio
phenomenon, where sound-induced dizziness occurs9, as
is the case in this report.
We developed an ICF assessment sheet to analyze this case. Using
different sources of information like anamnesis- interview, WHODAS 2.0,
videonystagmography, v-Hit, c-VEMP, and CT. We created a functioning
profile (Figure 2 )where we selected specific categories
according to patient necessities. The areas analyzed were body
functions, structures, activity and participation, and environmental
factors.
In the first domain, body functions, the patient manifests most
impairment in hearing (b230) and vestibular function(b235), moderate and
severe, respectively. We worked with the inner ear structure(s260) for
body structure; the classification was severe, the nature is ”aberrant
dimension,” and the location is 3, meaning ”both.”
The activity and participation were analyzed according to patient
requirements; listening (d115), conversation(d350), and washing body
parts(d5100)were categories that the patient claimed like relevant in
his life and about the qualification are severe limitation in
functioning profile. According to the interview, remunerative employment
(d850) and recreation and leisure(d920) are mild restriction. In the
environmental factors, we described his facilitators as ”products and
technology for employment and precuts and technology for culture,
recreation, and sport, e135 and e140, respectively. Nevertheless, we can
describe barriers, sound (e250), and vibration(e225), two variables
essentials to consider; the first one have a mild impairment, and the
second is severe.
The use of the International Classification of Functioning, Disability,
and Health (ICF) in the field of otoneurology can be a great help in the
evaluation and clinical reasoning for diagnosis and
treatment10-13. As previously mentioned, the patient
expressed that auditory difficulties were the most challenging,
affecting their performance and daily activities. This is supported by
evidence suggesting that patients with SSCD often experience auditory
difficulties6-8,14-15. Although B-SCD is atypical, its
structural characteristics are clearly described16. As
a structural condition, does its solution necessarily require a
structural approach. This is where the functioning profile of the ICF
helped guide this clinical case. The intervention focused on performance
education in daily variables such as personal hygiene, adapting work
methods, providing education about the patient’s health condition, and
avoiding triggering factors such as sound and vibration. The patient was
educated about possible surgical interventions and the importance of
monitoring the dehiscence and its symptoms. Therefore, this evaluation
method is recommended for healthcare teams to guide intervention
decisions best for patients.