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.