Superior canal dehiscence (SSCDS)
What the FAA's documents say about superior canal dehiscence (SSCDS), in plain words, with the FAA's own words one press away.
FAA term: Superior Semicircular Canal Dehiscence Syndrome (SSCDS)Covers: All classes
Short version
The disposition table has two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AAn incidental finding on imaging, and no symptoms | Examiner issues | Examiner can issue |
| Row BA history of symptoms | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Superior canal dehiscence (SSCDS)
- Row A · Examiner can issue
An incidental finding on imaging, and no symptoms. The table's footnote says symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis. The examiner should obtain why the imaging was performed, and reviews a detailed clinical progress note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies an incidental finding on imaging, that the individual never had symptoms, and no required treatment, and the examiner verifies no symptoms since diagnosis and that there is no other condition found (which warranted imaging), the table says ISSUE. The examiner annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file. If there are any symptoms, the row says go to Row B, and if another condition is found, it says see that page.
A. Incidental finding on imaging AND NO symptoms The AME should obtain why the imaging was performed. Review a detailed, Clinical Progress Note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies: • An incidental finding on imaging; • The individual never had symptoms*; and • No required treatment AND The AME verifies no symptoms since diagnosis and there is no other condition found (which warranted imaging): If ANY symptoms, go to Row B. *Symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis. If another condition is found, see that page. ISSUE Annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
- Row B · Special Issuance
A history of symptoms. The row's evaluation data opens with "After:" and lists one (1) month after surgery, released to full duties by the treating physician, no further vertiginous attacks, and hearing remains within standards. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the Authorization Letter.
B. History of symptoms After: • One (1) month after surgery; and • Released to full duties by the treating physician; and • No further vertiginous attacks; and • Hearing remains within standards. Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the Authorization Letter
The FAA pathways for superior canal dehiscence (SSCDS)
Which exam
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: the ENT note and what is verified
An incidental finding on imaging, and no symptoms.A detailed progress note from ENT (otolaryngology), performed any time after identification on imaging. Your AME reviews it, and should also obtain why the imaging was performed.
If the ENT evaluation verifies
- An incidental finding on imaging
- You never had symptoms
- No required treatment
And your AME verifies
- No symptoms since diagnosis
- No other condition found (which warranted imaging)
Where the row points elsewhere
- If there are any symptoms, the table says go to Row B
- If another condition is found, it says see that page, and names no page
At the exam
- Your AME annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file
Show the FAA's words: Row A: the ENT note and what is verified
Review a detailed, Clinical Progress Note from ENT (otolaryngology) performed any time after identification on imaging.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
If the ENT evaluation verifies: • An incidental finding on imaging; • The individual never had symptoms*; and • No required treatment
*Symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
AND The AME verifies no symptoms since diagnosis and there is no other condition found (which warranted imaging):
ISSUE
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
A. Incidental finding on imaging AND NO symptoms The AME should obtain why the imaging was performed.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
ISSUE Annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
If ANY symptoms, go to Row B.
If another condition is found, see that page.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The examiner should obtain why the imaging was performed, and reviews a detailed clinical progress note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies an incidental finding on imaging, that the individual never had symptoms, and no required treatment, and the examiner verifies no symptoms since diagnosis and that there is no other condition found (which warranted imaging), the table says ISSUE. The examiner annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file. If there are any symptoms, the row says go to Row B, and if another condition is found, it says see that page.Exam day- The examiner should obtain why the imaging was performed, and reviews a detailed clinical progress note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies an incidental finding on imaging, that the individual never had symptoms, and no required treatment, and the examiner verifies no symptoms since diagnosis and that there is no other condition found (which warranted imaging), the table says ISSUE. The examiner annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file. If there are any symptoms, the row says go to Row B, and if another condition is found, it says see that page.
Show the FAA's words: See your AME
A. Incidental finding on imaging AND NO symptoms The AME should obtain why the imaging was performed. Review a detailed, Clinical Progress Note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies: • An incidental finding on imaging; • The individual never had symptoms*; and • No required treatment AND The AME verifies no symptoms since diagnosis and there is no other condition found (which warranted imaging): If ANY symptoms, go to Row B. *Symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis. If another condition is found, see that page. ISSUE Annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
FAA source: Superior Semicircular Canal Dehiscence Syndrome (SSCDS). FAA date 29 November 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
The examiner should obtain why the imaging was performed, and reviews a detailed clinical progress note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies an incidental finding on imaging, that the individual never had symptoms, and no required treatment, and the examiner verifies no symptoms since diagnosis and that there is no other condition found (which warranted imaging), the table says ISSUE. The examiner annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file. If there are any symptoms, the row says go to Row B, and if another condition is found, it says see that page.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the Authorization Letter.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
An incidental finding on imaging, and no symptoms. The table's footnote says symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis. The examiner should obtain why the imaging was performed, and reviews a detailed clinical progress note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies an incidental finding on imaging, that the individual never had symptoms, and no required treatment, and the examiner verifies no symptoms since diagnosis and that there is no other condition found (which warranted imaging), the table says ISSUE. The examiner annotates Block 60 and submits the ENT evaluation to the FAA for retention in the file. If there are any symptoms, the row says go to Row B, and if another condition is found, it says see that page.
A. Incidental finding on imaging AND NO symptoms The AME should obtain why the imaging was performed. Review a detailed, Clinical Progress Note from ENT (otolaryngology) performed any time after identification on imaging. If the ENT evaluation verifies: • An incidental finding on imaging; • The individual never had symptoms*; and • No required treatment AND The AME verifies no symptoms since diagnosis and there is no other condition found (which warranted imaging): If ANY symptoms, go to Row B. *Symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis. If another condition is found, see that page. ISSUE Annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
- Row B · Special Issuance
A history of symptoms. The row's evaluation data opens with "After:" and lists one (1) month after surgery, released to full duties by the treating physician, no further vertiginous attacks, and hearing remains within standards. The table lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the Authorization Letter.
B. History of symptoms After: • One (1) month after surgery; and • Released to full duties by the treating physician; and • No further vertiginous attacks; and • Hearing remains within standards. Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the Authorization Letter
If the examiner defersSpecial Issuance
The table marks Row B, a history of symptoms, DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note from a clinic visit with the treating ENT (otolaryngologist), preferably a neurotologist, including what the table lists. The clinic visit should be no more than 90 days before the exam.
- Item 2. Items the physician specifically addresses: if active disease exists and, if in remission, when remission commenced. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
- Item 3. A current clinical audiogram with air-conduction/bone-conduction (AC/BC) and speech discrimination (SD), performed within the past 90 days.
- Item 4. Additional tests, such as ECOG, VEMP, or an MRI with gadolinium of the cerebellopontine angle (CPA), etc., performed as clinically indicated.
- Item 5. All office treatment records.
- Item 6. A copy of the operative report, if surgery was performed.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, a history of symptoms, DEFER.
B. History of symptoms … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed clinical progress note from a clinic visit with the treating ENT (otolaryngologist), preferably a neurotologist, including what the table lists. The clinic visit should be no more than 90 days before the exam.
1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ENT (otolaryngologist), preferably a neurotologist (a sub-specialty of ENT/otolaryngology). The clinic visit should be no more than 90 days prior to the AME exam. It must include:
- Item 2
Items the physician specifically addresses: if active disease exists and, if in remission, when remission commenced. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
2. It must specifically include: • If active disease exists. • If in remission, when did remission commence.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
- Item 3
A current clinical audiogram with air-conduction/bone-conduction (AC/BC) and speech discrimination (SD), performed within the past 90 days.
3. Current clinical audiogram with Air-Conduction/Bone-Conduction (AC/BC) and Speech Discrimination (SD) (performed within the past 90 days).
- Item 4
Additional tests, such as ECOG, VEMP, or an MRI with gadolinium of the cerebellopontine angle (CPA), etc., performed as clinically indicated.
4. Additional tests such as (ECOG, VEMP, MRI with Gadolinium of the cerebellopontine angle [CPA], etc.) performed as clinically indicated.
- Item 5
All office treatment records.
5. All Office treatment records.
- Item 6
A copy of the operative report, if surgery was performed.
6. Copy of Operative report (if surgery performed).
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workAt later examsSpecial Issuance
The disposition table is headed All Classes.
Show the FAA's words: how often the FAA asks again
Superior Semicircular Canal Dehiscence Syndrome (SSCDS) All Classes
For Row B the table says follow-up issuance will be per the Authorization Letter.
Show the FAA's words: at later exams
Follow up Issuance Will be per the Authorization Letter
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workFollow-up issuance per the Authorization Letter
For Row B the table says follow-up issuance will be per the Authorization Letter.
Show the FAA's words: Follow-up issuance per the Authorization Letter
Follow up Issuance Will be per the Authorization Letter
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
What the table counts among symptoms
Row A says that if there are any symptoms, go to Row B. The table's footnote says symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis.
Show the FAA's words: good to know, 2
If ANY symptoms, go to Row B. *Symptoms may include vertigo induced by a loud noise, autophonia, chronic imbalance, tinnitus, and hyperacusis.
Row A's ENT note and Row B's progress note differ
For Row A the table has the examiner review a detailed clinical progress note from ENT performed any time after identification on imaging. For Row B it asks for a current, detailed clinical progress note from a clinic visit with the treating ENT, and says the clinic visit should be no more than 90 days before the exam.
Show the FAA's words: good to know, 3
Review a detailed, Clinical Progress Note from ENT (otolaryngology) performed any time after identification on imaging. … 1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ENT (otolaryngologist), preferably a neurotologist (a sub-specialty of ENT/otolaryngology). The clinic visit should be no more than 90 days prior to the AME exam.
Under Row A the ENT evaluation goes to the FAA
Row A is ISSUE, and the table has the examiner annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
Show the FAA's words: good to know, 4
ISSUE Annotate Block 60 and submit the ENT evaluation to the FAA for retention in the file.
Row B's list opens with surgery
Row B's evaluation data opens with "After:" and lists one (1) month after surgery, released to full duties by the treating physician, no further vertiginous attacks, and hearing remains within standards. Its item 6 asks for a copy of the operative report if surgery was performed. The table does not say how the first line applies where there was no surgery.
Show the FAA's words: good to know, 5
After: • One (1) month after surgery; and • Released to full duties by the treating physician; and • No further vertiginous attacks; and • Hearing remains within standards. … 6. Copy of Operative report (if surgery performed).
If another condition is found
Row A says that if another condition is found, see that page. It does not name the page.
Show the FAA's words: good to know, 6
If another condition is found, see that page.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Superior Semicircular Canal Dehiscence Syndrome (SSCDS)Open to print: Superior Semicircular Canal Dehiscence Syndrome (SSCDS), a PDF at the FAA, in a new tab
Examiner can issue, Special Issuance
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.