The semicircular canals are filled with a fluid called endolymph which has hair cells embedded within. To understand the pathophysiology of SSCD, it is important to first review the anatomy of the inner ear and vestibular system. SSCD is a relatively new condition, first described in 1998 by Minor et al. This case report will provide insight on the conservative management of a particular vestibular pathology known as superior semicircular canal dehiscence (SSCD). There are numerous vestibular conditions, many of which are treatable with vestibular rehabilitation. Pathology or dysfunction of the vestibular system can lead to impairments of balance and overall postural control. The information from this case can be used to guide the effective treatment of similar patients diagnosed with vestibular dysfunction. Discussion: For a patient with a complex otologic history and a current diagnosis of bilateral SSCD, vestibular rehabilitation was an effective management option. The patient had plans to pursue surgical intervention within the next year. She was able to play her flute for 20-minute intervals, play with her dogs, partake in social gatherings, and drive for 5 hours without symptoms. The patient improved in all her activity limitations and participation restrictions. Outcomes: After eleven weeks of physical therapy, the patient made improvements on the Lower Extremity Functional Scale (43/80 to 52/80), the Dynamic Gait Index (19/24 to 24/24), the Dizziness Handicap Inventory (86/100 to 68/100), and the Sharpened Romberg (2 seconds to >30 seconds). Physical therapy services were provided for approximately 11 weeks with a frequency of two times per week. Interventions: Specific interventions included vestibular habituation and adaptation exercises, balance and gait training, and patient education. Her participation restrictions include taking part in social gatherings, going to church, driving longer than 30 minutes, playing with her dogs, and teaching flute lessons. Her activity limitations include lower extremity dressing, driving, and playing her flute. The patient’s body structure and function impairments include constant headaches, dizziness with head rotation and eye movements, sensitivity to sounds and lights, and instability during gait. Case Description: The patient was a 56-year-old woman with a long-standing otologic history involving bilateral SSCD and EH. The purpose of this case report is to describe the effects of physical therapy in the treatment of a patient diagnosed with bilateral SSCD. Moreover, we recommend using the DHI total score only and also to consider adding an instrument with more favorable measurement properties when assessing self-perceived handicap in patients with dizziness.Ĭopyright © 2022, Otology & Neurotology, Inc.Background and Purpose: Despite the strong body of evidence for vestibular rehabilitation, research is lacking for effective clinical management of patients with superior semicircular canal dehiscence (SSCD) and endolymphatic hydrops (EH).

Because of its widespread use and the current lack of a better alternative, researchers can use the DHI when assessing handicapping effects imposed by dizziness, but they should be aware of its limitations. The current evidence for a number of measurement properties of the DHI is suboptimal. No evidence synthesis could be done for the DHI's internal consistency due to multidimensionality (i.e., lack of support of the original subscales) and for its measurement error due to a lack of published information on the minimal important change. Based on the studies included, low evidence was found for sufficient reliability of the DHI total score. Moderate evidence was found for inconsistent structural validity, sufficient construct validity and borderline sufficient responsiveness. Overall, evidence on the DHI's content validity was either lacking or limited and of low quality. The search strategy resulted in 768 eligible publications, 42 of which were included in the review. From the included studies, relevant data were extracted, their methodological quality was assessed, the results were synthesized and the evidence was graded and summarized according the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. The selected literature databases were systematically searched to identify studies investigating one or more measurement properties of the DHI.

To critically appraise and summarize the quality of the measurement properties of the Dizziness Handicap Inventory's (DHI) in adult patients with complaints of dizziness.

Mcid dizziness handicap inventory