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Pulsatile nystagmus secondary to semicircular canal dehiscence
  1. Mohamed Hawwas1,
  2. Emily Young2,
  3. Virangna Taneja3 and
  4. Darius Rejali4
  1. 1 Department of Surgery, Ministry of Health-Dakahlia Directorate, Mansoura, Egypt
  2. 2 ENT Department, St Paul’s Rotary Clinic, Vancouver, British Columbia, Canada
  3. 3 ENT Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  4. 4 Department of Otolaryngology, University Hospital Coventry, Coventry, Coventry, UK
  1. Correspondence to Dr Emily Young, ugm9ery{at}


We report the case of a 69-year-old man with a history of mastoidectomy for cholesteatoma, who developed spontaneous spinning vertigo on debridement of his cavity. Subsequent CT confirmed a lateral semicircular canal fistula, which was surgically closed with mastoid cavity obliteration. Following surgery, he developed a spontaneous, pulse-synchronous horizontal pendular nystagmus. We discuss the pathophysiology of this rare clinical sign.

  • ear, nose and throat/otolaryngology
  • neurootology
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  • Contributors MH and EY were responsible for the drafting of report and revision of final manuscript. EY was responsible for the submission of manuscript and correspondence. VT helped with drafting of report and discussion. DR contributed to the initial concept, patient consent and review of final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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