Occlusion of the Round Window: A Novel Way to Treat Hyperacusis Symptoms in Superior Semicircular Canal Dehiscence

Objective: Conductive hyperacusis in SSCDS occurs because of presence of a “third window.” This can cause an increased imbalance in the impedances looking out of the cochlear windows. Reversible blocking of the round window can minimize symptoms of conductive hyperacusis. Method: The tympanomeatal flap is elevated through a permeatal approach. The round window niche is identified, and the round window membrane is identified and occluded with bone wax and fascia in layers. Finally the tympanomeatal flap is reflected, and an ear wick is inserted. Results: Two patients who have undergone the above procedure have reported great reduction in symptoms. Importantly, no Tullio phenomenon has been noted postoperatively. Conclusion: In patients with SSCD syndrome who present with symptoms of conductive hyperacusis, blocking of the round window can be used to control symptoms. It provides an alternative to the plugging and resurfacing techniques. This procedure is simple to perform, is reversible, and can be undertaken as a day case.