Patient Sex Mediates the Influence of Patient Age on Superior Canal Dehiscence Repair Outcome

ObjectiveTo investigate the independent and interactive effects of patient age and sex on superior canal dehiscence (SCD) repair outcomes.MethodsThis was a cohort study of consecutive SCD repairs via the middle fossa approach at an institution between 2011 and 2022. We constructed multivariable regression models assessing surgical outcomes with age and sex as the primary predictors. Models controlled for surgery duration, follow-up duration, and relevant surgical and medical history. Subsequently, we repeated each model with the incorporation of an interaction term between patient age and sex.ResultsAmong 402 repairs, average age was 50 years, and 63% of cases were females. There was a significant interaction between patient age and sex with respect to symptom resolution score (SRS) (adj. beta 0.80, 95% C.I. 0.04-1.56). Older age was associated with lower SRS among females (-0.84, -1.29 to -0.39 point per year) but not significantly associated with SRS among males (0.04, -0.65 to 0.56 point per year). Furthermore, older age independently predicted a greater magnitude of increase in air conduction at 8000 Hz following surgery regardless of sex (adj. beta 2.1, 0.2-4.0 dB per 10-year increase).ConclusionsThis is the first study on the interactive effect between patient age and sex with respect to SCD repair outcomes. Older age predicted poorer symptomatic response among female patients but did not predict symptomatic response among male patients. Furthermore, older age predicted more severe high-frequency hearing loss following SCD repairs among both female and male patients.Level of Evidence3 Laryngoscope, 2024 In this cohort study of 402 SCD repairs, older age predicted poorer symptomatic response among females but not did not predict symptomatic response among males. Older age predicted more severe high-frequency hearing loss following surgery regardless of sex. image