Do you also experience frequent dizziness? Do you hear strange noises in your ears? It could be Superior Canal Dehiscence Syndrome (SCDS)!

Do you sometimes hear the sound of your own breathing, the sound of your eyes blinking, or the sound of your own voice echoing loudly in your ears when you speak? Or do you suddenly feel dizzy for no reason, or things around you spinning like a spinning top? Don't just dismiss these as just physical fatigue. Because these can be symptoms of a rare but treatable condition if diagnosed correctly. Today, we'll talk about this condition called `Superior Canal Dehiscence Syndrome`, or `(SCDS)` for short.

What is `Superior Canal Dehiscence Syndrome (SCDS)`? Let's understand it very simply.

Simply put, SCDS is a rare condition that affects your inner ear . It can affect your balance and hearing. Imagine that inside your ear, like a small maze, there are three very fine tubes filled with fluid. These are called the semicircular canals. Between these tubes, at the top, which is a little closer to the brain, is the superior semicircular canal. When we move our heads or move our bodies, the fluid inside these tubes moves with them. The movement of that fluid sends signals to our brain that "the position of our body is changing." The brain uses this information to control our balance . Now, in the case of `SCDS`, a small hole or a very thin (dehiscence) develops in the protective bony covering around the canal at the top (`superior semicircular canal`), that is, in that strong wall. It is like a small hole in a water pipe. This hole can cause some problems in that signaling system. Also, normal sounds that occur inside the ear (for example, the sound of breathing, the sound of blinking) can go through this hole to the brain, making them seem louder, and other hearing problems can occur. This condition called `SCDS` is called by several other names, but the most commonly used name is `SCDS`.

How common is this `SCDS` condition?

This is a very rare condition . It is estimated that between 1% and 2% of the general population may have this condition. Some people may have this condition in both ears (`bilateral superior semicircular canal dehiscence`). However, even then, symptoms are usually felt more in one ear.

What symptoms might someone with `SCDS` experience?

This is the most important thing. Not everyone has all the symptoms. So sometimes it can be a little difficult to recognize it exactly. The other thing is that some people may not show any symptoms even if the bone is thin or has a small hole. Also, people who do not have an actual hole in the bone, but just thin, can have the same symptoms as those who have a hole. However, if symptoms do appear, they can affect your daily life. The main effects are hearing and balance . This can also cause some mental distress.

Hearing problems:

• ` Autophony` : This is when you hear your own voice, the sound of your breathing, the sound of your chewing food, and sometimes even the sound of your eyes blinking, very loudly and clearly inside your ears. It can feel like you have a microphone turned up inside your head.
• `Hyperacusis` (hyperacusis): A condition in which you hear sounds that we normally hear as very loud, annoying, and sometimes painful . Even a small sound can be unbearable.
• Pulsatile tinnitus : A ringing sound inside your head or ears that is in sync with your heartbeat (pulse) .
• Hearing Loss : Hearing loss may occur, especially at low frequencies .

Problems related to body balance:

• ` Vertigo `: A feeling that things around you are spinning, or that you are spinning, even when you are standing still. This can be a very uncomfortable and frightening experience.
• `Oscillopsia` (visual oscillation): The sensation that something you are looking at is moving, going up and down, or swaying from side to side, even when it is still. It's like a camera being shaken while recording a video.

In particular, these `Vertigo` (dizziness) and `Oscillopsia` (visual oscillations) conditions can increase when doing things that change the pressure in the head or inside the ear (for example, coughing hard, sneezing, lifting heavy objects, flushing the toilet, etc.) and when exposed to loud noises . Imagine, you are about to lift a small weight and suddenly your head starts spinning!

Effects on mental health:

When severe symptoms like these persist, it can also negatively affect your mental health.

• Headache .
• `Brain fog`:It's hard to think straight, and you feel like you're not clear-headed.
• Memory problems.

When you try to stay away from society and stay at home to escape these uncomfortable sounds and dizziness, situations like loneliness, anxiety, and even depression can arise.

Why does this `SCDS` occur? What are the causes?

In fact, the exact cause of SCDS is still not known. It may be congenital. That is, during fetal life, the bone around the superior canal is not thick enough. Other researchers suggest that this condition can also be caused by certain infections or head trauma . Most likely, there is more than one cause. For example, when you are born, there is a thin spot in the bone, and later, another accident or infection can cause it to become thinner and a hole can form. Or, the bone can gradually thin out as you age and this condition develops.

How is SCDS accurately diagnosed?

If you have these symptoms, the first thing you should do is see a qualified doctor. There are specialists for these conditions. Usually , you should see a neurologist. He or she will ask you about your symptoms, how they started, and how often they have worsened. He or she will then order several tests to rule out other common conditions that have similar symptoms to SCDS and to confirm the diagnosis of SCDS. The main tests that are performed are:

• CT scan (Computed Tomography scan) of the bones surrounding the ear: This is a high-resolution CT scan. It can clearly see if there is a hole or thinning in the bone around the superior semicircular canal.
• Hearing test: This is done by an audiologist. This tests your hearing, especially low-frequency sounds.
• `VEMP` (Vestibular-Evoked Myogenic Potential) test: This can provide information about how the different parts of your inner ear that are involved in balance are working. This is a painless test. All you have to do is look left, right, or up while looking at a target or listening to certain sounds. People with `SCDS` may see a specific response pattern during this `VEMP` test.

What are the treatments for `SCDS`?

For many people, making small changes to their lifestyleYou can live with the condition by avoiding things that make you feel dizzy and dizzy (oscillopsia), for example, by avoiding activities that cause dizziness and the sensation of objects moving (such as heavy lifting, sneezing or coughing), and by staying away from noisy environments. Some people use earplugs or earmuffs to reduce the amount of noise they hear. Also, seeing a physical therapist who is trained in balance (a vestibular physical therapist) can help you manage your symptoms. They can teach you exercises to improve your balance and reduce your risk of falling. However, if these things do not control the symptoms, or if the symptoms are significantly affecting your quality of life, then surgery may be necessary to plug or resurfacing the hole .

Surgeries for `SCDS` (`SCDS surgery`)

There are several main types of surgery performed for SCDS:

• Plugging the dehiscence - Middle Cranial Fossa Approach: This involves completely closing the hole in the bone. This involves making a small incision on the side of the skull to access the inner ear. This surgery is usually performed by an ear , nose, and throat specialist ( ENT specialist) and a neurosurgeon.
• Plugging the dehiscence - Transmastoid approach: In this method, the inner ear is accessed by making a small opening behind the ear.
• Resurfacing: This involves covering the hole without completely closing it. This is not as common as plugging.

Sometimes doctors may use both `plugging` and `resurfacing` techniques during surgery.

What are the possible complications of surgery?

The risk of major complications after an SCDS operation is very low. As with any surgery, there is a small risk of infection. There may be some slight problems with balance for the first week or so after surgery, as the body adjusts to the new position. However, this usually improves within a few days.

Will the `SCDS` situation automatically improve?

No. SCDS does not heal on its own without surgery. Unlike other bones in our body, the bone around the superior semicircular canal does not heal on its own. As you learn ways to manage your symptoms, you may find some relief. However, SCDS will not go away completely without treatment.

How successful is the `SCDS` surgery?

Many people's symptoms are reduced or completely eliminated with the `SCDS` surgery.Some studies have shown that some symptoms improve more quickly after surgery than others. For example, hearing loss, autophony, pulsatile tinnitus, and vertigo may improve quickly. However, headaches and brain fog may take longer to improve. Talk to your doctor about the results of surgery, depending on your symptoms and the size of the hole.

How do I take care of myself with this condition?

If you are diagnosed with SCDS, it is important to follow your doctor's instructions. In many cases, symptoms can be managed by making lifestyle changes. Here are some things you can do:

• Using earplugs .
• Avoid noisy environments whenever possible.
• If your voice sounds painful to you, speak softly (`whispering`).
• Avoiding activities that affect balance, such as weight lifting.
• Avoiding activities that can change ear pressure (e.g., flying) as much as possible.
• At work, if possible, ask for a quiet, private space instead of a shared space .

Remember, you are not alone. It is normal to experience some emotional distress when living with a condition like this. If necessary, talk to your doctor about it.

Finally, things to remember (Take-Home Message)

If you have been diagnosed with Superior Canal Dehiscence Syndrome (SCDS), don't panic. Many people manage their symptoms by making lifestyle changes. Your doctor will recommend ways to help you prevent symptoms that affect your balance and/or hearing from getting worse. In some cases, if your symptoms are severe, surgery can close the hole in the bone and reduce or eliminate symptoms. Talk to your doctor about the best treatment option for you. Remember, getting a proper diagnosis and treatment can help you get relief.