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Canal Plane Dynamic Visual Acuity in Superior Canal Dehiscence

Janky, Kristen L.*†; Zuniga, M. Geraldine*; Ward, Bryan*; Carey, John P.*; Schubert, Michael C.*‡

doi: 10.1097/MAO.0000000000000336
Vestibular Disorders

Objective 1) To characterize normal, horizontal active dynamic visual acuity (DVA) and passive canal plane head thrust DVA (htDVA) across ages to establish appropriate control data and 2) to determine whether horizontal active DVA and passive canal plane htDVA are significantly different in individuals with superior canal dehiscence syndrome (SCDS) before and after surgical repair in the acute (within 10 d) and nonacute stage (>6 wk).

Study Design Prospective study.

Setting Tertiary referral center

Patients Patients diagnosed with SCDS (n = 32) and healthy control subjects (n = 51).

Interventions Surgical canal plugging on a subset of patients.

Main Outcome Measures Static visual acuity (SVA), active horizontal DVA, and canal plane htDVA.

Results Visual acuity (SVA, active DVA, and htDVA) declines with age. In SCDS, SVA and active DVA are not significantly affected in individuals after surgical canal plugging; however, htDVA in the plane of the affected canal is significantly worse after canal plugging.

Conclusion Age-based normative data are necessary for DVA testing. In SCDS, htDVA in the plane of the affected canal is normal before surgery but permanently reduced afterward.

*Johns Hopkins University, Otolaryngology – Head and Neck Surgery, Baltimore, Maryland; †Boys Town National Research Hospital, Department of Audiology, Omaha, Nebraska; and ‡Johns Hopkins University, Physical Medicine and Rehabilitation, Baltimore, Maryland, U.S.A.

Address correspondence and reprint requests to Michael Schubert, Ph.D., Johns Hopkins University, Otolaryngology – Head and Neck Surgery, Physical Medicine and Rehabilitation, 601 N. Caroline Street 6th Floor, Baltimore, MD 21287-0910, USA; E-mail:

This research study was supported by the following mechanisms: National Institutes of Health (NIH)/National Institute on Deafness and Other Communication Disorders (NIDCD) R01 DC005040 (Evaluation of Vestibular Function in Ménière’s Disease; PI: John Carey, M.D.), NIDCD K23-007926 (Incremental VOR Adaptation and Utility of Saccades as Rehabilitation Strategies; PI: Michael Schubert, Ph.D.), and NIH Training Grant T32DC000023 (PI: Eric Young, Ph.D.).

The authors disclose no conflicts of interest.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company