Table 2.
Patient demographics, history, symptoms, and results of diagnostic studies in 16 patients with cochlea-facial nerve dehiscence.
| Group 1: Cochlea-facial nerve dehiscence and third window syndrome patients who underwent round window reinforcement surgery | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient (age at surgery) | Sex | Cognitive dysfunction | Spatial disorientation | Anxiety | Nausea | Migraine/Migrainous Headache | Duration of medical migraine management before surgery | Pre-trauma migraine | Trauma | Surgery performed (length of follow-up) | High-resolution TB CT |
| 1* (12.75) | M | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; difficulty reading; Impaired memory | No | No | Yes | Daily migraine HA, infrequent ocular migraine | 2.5 months | Rare migraine HA | Football concussion, TWS after vigorous nose blowing during acute sinusitis | L RWR (52 months) | L CFD |
| 2* (12.92) | M | Impaired attention and concentration; difficulty reading; Impaired memory | Rare difficulty with judging distances and sense of detachment | No | No | 24/7, light sensitivity | 15 months | None | Snowboarding accident, LOC | L RWR R RWR (71 months) |
L CT– TWS RCFD |
| 3 (15.17) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; Impaired memory | No | No | No | 3 days clusters of migraine HA, light sensitivity, occasional ocular migraine | 27 months | Childhood migraine HA, infrequent | Mononucleosis/ pneumonia, severe coughing |
R RWR (10 months) |
R CFD Lnear-CFD |
| 4 (16.5) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; difficulty in name finding; difficulty reading; Impaired memory | Mild difficulty judging distances, particularly in cars | No | Once | 24/7, light sensitive, vestibular migraine with rotational vertigo, occasional ocular migraine | 13 months | None | Concussion, basketball blow to head, sinus infection with vigorous nose blowing | L RWR (49 months) | L CFD |
| 5* (17.19) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; slurred speech; difficulty in name finding; Impaired memory | Difficulty judging distances; sense of detachment | No | No | Constant headache and daily migraine HA | 21 months | Concussions (3), onset of symptoms after severe vomiting during influenza infection | R RWR (69 months) | R CFD | |
| 6* (19.0) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; slurred speech; difficulty in name finding; Impaired memory (lost her photographic memory) | Difficulty judging distances; sense of detachment | Sense of impending doom | Yes (constant) | Frequent migraine HA, light sensitivity, ocular migraine (2), vestibular migraine with rotational vertigo | 85 months | Migraine HA history began at age 11 years | Concussions (3) | R RWR (11 months) | R CFD |
| 7* (51.42) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; slurred speech; difficulty in name finding; slurred speech; difficulty in name finding; Impaired memory | Difficulty in judging distances; sense of detachment; perception of walls breathing | Sense of impending doom | Yes | Daily migraine HA | 22 months | None | MVA with airbag deployment | L RWR (12 months) | L CFD |
| 8 (52.92) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; Impaired memory | Difficulty in judging distances; sense of detachment; occasional out of body experiences | No | Yes (extreme) | Chronic migraine HA, ocular migraine once monthly, infrequent vestibular migraine with rotational vertigo | 16 months | Adult onset migraine HA clusters with menstrual cycle | MVA | R RWR (37 months) | R CFD |
| Group 2: Cochlea-facial nerve dehiscence and third window syndrome patients who did not undergo round window reinforcement surgery | |||||||||||
| Patient (age at presentation) | Sex | Cognitive dysfunction | Spatial disorientation | Anxiety | Nausea | Migraine/Migrainous Headache | Duration of medical migraine management before surgery | Pre-trauma migraine | Trauma | Surgery performed | High-resolution TB CT |
| 1 (6.65) | M | Unknown | Unknown | Unknown | Yes | Weekly migraine HA, intermittent vestibular migraine | NA | NA | None | None | Bilateral CFD (R > L) |
| 2 (7.58) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; difficulty reading; Impaired memory | Difficulty judging distances | No | No | Weekly migraine HA, vestibular migraine with rotational vertigo 1 time per week | NA | NA | None | None | L CFD |
| 3 (27.88) | F | Mild impaired attention, concentration and memory | No | No | Yes | Daily migraine HA, ocular migraines (2) | NA | Migraine HA 2 times per week, ocular migraine (1) | Taxi trunk lid “slammed” on head | None | L CFD |
| 4 (28.71) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; difficulty reading; Impaired memory and forgetful | Difficulty in judging distances; sense of detachment; perception of walls and floor moving | No | Yes | Daily HA with severe migraine HA 2–3 times per week, occasional vestibular migraine with rotational vertigo | NA | None | MVA with mTBI | None | Bilateral CFD (L > R) |
| 5 (30.27) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; occasional slurred speech; difficulty reading; Impaired memory | Difficulty in judging distances; sense of detachment; perception of walls moving | No | Yes | Migraine HA 2–3 times per week, occasional perimenstrual vestibular migraine with rotational vertigo, ocular migraine (1) | NA | Onset migraine HA age 5 | None | None | Bilateral CFD |
| 6 (34.61) | M | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; occasional slurred speech; difficulty in name finding; Impaired memory | Perception of walls swaying; perceives room proportions distorted | No | Yes | Nearly constant migraine HA | NA | “Sinus headaches” | None; onset symptoms after 4 days of Adderall | None | L CFD or near-CFD |
| 7 (54.71) | M | No | No | No | Yes | Vestibular migraine with rotational vertigo, no migraine HA | NA | NA | None | None | L CFD |
| 8 (55.67) | F | Impaired attention and concentration; dysnomia, agrammatical speech and aprosdia; occasional slurred speech; difficulty in name finding; Impaired memory | Difficulty in judging distances | No | Yes | Occasional migraine HA | NA | NA | None | None | L CFD |
*
See video links in references (15–19) [Cohort 1: subject 1 (15), subject 2 (16), subject 5 (17), subject 6 (18), subject 7 (19)]; 24/7 = migraine headache present constantly, 24 h per day and 7 days per week while awake; CFD, cochlea-facial nerve dehiscence; CT, computed tomography scan; CT–, CT negative (no dehiscence seen on CT); F, female; HA, headache; L, left; LOC, loss of consciousness; M, male; mTBI, mild traumatic brain injury; MVA, motor vehicle accident; TB, temporal bone; R, right. The classification of headache and migraine used in this study followed the International Headache Society's International Classification of Headache Disorders, 3rd edition (ICHD3).