Minimally-invasive middle fossa craniotomy approach with endoscopic repair of superior canal dehiscence

Superior canal dehiscence (SCD) is a bony defect of the superior semicircular canal (SSC). SCD syndrome (SCDS) occurs when vestibular or auditory dysfunction accompanies SCD. While not all SCD patients are symptomatic, surgical repair is an option in patients with incapacitating symptoms and unresponsive to conservative treatment. Traditionally, repair of SCDS when involving the arcuate eminence can be achieved utilizing a middle fossa craniotomy (MFC) approach. However, approximately 30% of SCD cases have a medial arcuate eminence defect along a downsloping tegmen, making the defect difficult to visualize with the binocular microscope without a large craniotomy, extensive temporal lobe retraction and drilling of the skull base.

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