Abstract
Objective
Large vestibular aqueduct syndrome (LVAS) is one of the etiology of hearing loss.
Clinically, we observed that the VA size of patients with idiopathic sudden sensorineural
hearing loss (ISSNHL) did not meet the diagnostic criteria of VA enlargement, but
there were individual variations. Through this study, we want to understand the VA
development and explore its risk for suffering from ISSNHL.
Methods
74 patients with ISSNHL were retrospectively reviewed in our department from June
2018 to September 2021. Meanwhile, 57 people with no ear diseases were randomly selected
as the control group. All their clinical information were systematically collected.
The axial thin-slice CT images of temporal bone were used to observe and measure the
VA in ISSNHL and controls. ISSNHL were classified as different types and grades according
to pure tone audiometry and the degree of hearing loss, respectively. Logistic regression
analysis was adopted to evaluate the risk factors of different types and grades of
ISSNHL.
Results
The operculum morphology could be funnel-shaped, tubular and invisible, but they had
no statistical difference in the morbidity of ISSNHL. The operculum width of the affected
sides in the case group was significantly wider than that of the matched sides in
the control group (0.84±0.35mm vs 0.68±0.34mm, p=0.009), but the midpoint width had
no statistical difference (p=0.447). The operculum width was an independent risk factor
for the total hearing loss type (p=0.036, OR=4.49, 95% CI=1.10-18.29), moderate (p=0.013,
OR=17.62, 95% CI=1.82-170.95) and profound (p=0.031, OR=4.50, 95% CI=1.14-17.67) grade
of ISSNHL. Hypertension was an independent risk factor for the severe grade (p=0.004,
OR=12.44, 95% CI=2.19-70.64) of ISSNHL. Both the operculum width (p=0.048, OR=7.14,
95% CI=1.02-50.26) and hypertension (p=0.014, OR=6.73, 95% CI=1.46-30.97) were the
risk factors for the flat type of ISSNHL. The midpoint width of the VA, gender, age,
diabetes mellitus, hyperlipidemia, and plasma fibrinogen concentration had no significant
effect on the risk for suffering from ISSNHL.
Conclusion
The development of the VA operculum is a risk factor for some types and grades of
ISSNHL. Hypertension remained a risk factor for ISSNHL.
Key words
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Article info
Publication history
Published online: February 14, 2023
Accepted:
January 31,
2023
Received:
October 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
