Vestibular rehabilitation following surgical repair for Superior Canal Dehiscence Syndrome: A complicated case report

ABSTRACT

Superior Canal Dehiscence Syndrome (SCDS) causes auditory and vestibular symptoms. Following surgical repair of the dehiscence, patients often experience dizziness and imbalance. This case report describes a postoperative vestibular exercise program, focusing on the principles of central compensation and habituation, and how it was modified for a patient with delayed progress secondary to strabismus and visual vertigo. A 63-year-old male with history of strabismus eye surgery, right hearing loss, aural fullness, and sensitivity to loud sounds was referred for vestibular rehabilitation (VR). He was seen for one preoperative and six postoperative PT visits over eight months. Outcome measures two weeks postoperative were as follows: Dizziness Handicap Inventory (DHI) 38/100; Timed Up & Go (TUG) 9.92 seconds; Dynamic Gait Index (DGI) 16/24; and a 3-line difference in Dynamic Visual Acuity (DVA). Improved outcomes at discharge included: DHI 18/100; TUG 6.87 seconds; DGI 23/24; and 1-line difference in DVA. He was able to return to work and previously enjoyed recreational activities. Postoperative vestibular rehabilitation programs are functionally and symptomatically beneficial following surgical repair for SCDS. Deviations from expected recovery should be addressed to achieve optimal outcomes as demonstrated in this complicated case report.

KEYWORDS:

• Balance
• dizziness
• superior canal dehiscence
• syndrome
• vestibular rehabilitation
• visual vertigo

Acknowledgments

We would like to sincerely thank Dr. Min Huang, PT, PhD, NCS, Margot Beckerman, AuD, CCC-A, and Crystal Pitts, AuD, CCC-A, for their assistance in reviewing this manuscript and providing suggestions for improvement.

Declaration of interest

The authors report no declaration of interest.