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.
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.
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.
The development of the VA operculum is a risk factor for some types and grades of ISSNHL. Hypertension remained a risk factor for ISSNHL.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Auris Nasus Larynx
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinical practice guideline: sudden hearing loss (Update).Otolaryngol Head Neck Surg. 2019; 161: S1-45
- [Guideline of diagnosis and treatment of sudden deafness (2015)].Chin J Otorhinolaryngol Head Neck Surg. 2015; 50: 443-447
- Efficacy comparison of oral steroid, intratympanic steroid, hyperbaric oxygen and oral steroid + hyperbaric oxygen treatments in idiopathic sudden sensorineural hearing loss cases.Eur Arch Otorhinolaryngol. 2011; 268: 1735-1741
- Examining the validity of the World Health Organization's long-standing hearing impairment grading system for unaided communication in age-related hearing loss.Am J Audiol. 2019; 28: 810-818
- Adverse effects of glucocorticoid therapy for inner ear disorders.J Otorhinolaryngol Relat Spec. 2008; 70: 271-274
- Combination therapy (intratympanic dexamethasone + high-dose prednisone taper) for the treatment of idiopathic sudden sensorineural hearing loss.Otol Neurotol. 2008; 29: 453-460
Chen W, Geng Y, Luo S, Lin N, Sha Y. The correlation of clinical features and endolymphatic hydrops visualized by 3D-Real IR MRI in children with sudden sensorineural hearing loss. Ear Nose Throat J. 20211455613211009432.
- Analysis of clinical and laboratory findings of idiopathic sudden sensorineural hearing loss.Sci Rep. 2020; 10: 6057
- The biomechanical characteristics of human vestibular aqueduct: a numerical-based model construction and simulation.Comput Methods Biomech Biomed Engin. 2021; 24: 905-912
- Postnatal development of the vestibular aqueduct in relation to the internal auditory canal. Computer-aided three-dimensional reconstruction and measurement study.Ann Otol Rhinol Laryngol. 1994; 103: 719-722
- Vestibular aqueduct size correlates with the degree of cochlear hydrops in patients with and without Menière's disease.Otol Neurotol. 2021; 42: e1532-e15e6
- The large vestibular aqueduct syndrome.Laryngoscope. 1978; 88: 723-728
- Vestibular aqueduct in sudden sensorineural hearing loss.J Laryngol Otol. 2008; 122: 887-892
- Diabetes, cardiovascular risk factors and idiopathic sudden sensorineural hearing loss: a case-control study.Audiol Neurootol. 2010; 15: 111-115
- Morphological analysis of the vestibular aqueduct by computerized tomography images.Eur J Radiol. 2007; 61: 79-83
- Contralateral hearing loss in children with a unilateral enlarged vestibular aqueduct.Int J Pediatr Otorhinolaryngol. 2021; 150110891
- Sex-specific enlarged vestibular aqueduct morphology and audiometry.Am J Otolaryngol. 2019; 40: 473-477
- Development of the vestibular aqueduct in Menière's disease.Acta Otolaryngol Suppl. 1993; 504: 46-50
- Comparison between bilateral and unilateral sudden sensorineural hearing loss.Chin Med J (Engl). 2018; 131: 307-315
- Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss in children.Laryngoscope. 2015; 125: 2209-2215
- Comparison of sudden deafness in adults and children.Clin Exp Otorhinolaryngol. 2014; 7: 165-169
- Prognostic value of fibrinogen/HDL ratio in idiopathic sudden sensorineural hearing loss.J Int Adv Otol. 2021; 17: 91-95
- Clinical features and prognosis of severe-to-profound sudden sensorineural hearing loss.Am J Otolaryngol. 2022; 43103455
- Sudden sensorineural hearing loss: is there a relationship between routine haematological parameters and audiogram shapes?.Int J Audiol. 2017; 56: 148-153
- Serum fibrinogen as a prognostic factor in sudden sensorineural hearing loss: a Meta-analysis.Otol Neurotol. 2018; 39: e929-ee35
- Prognosis of low-tone sudden deafness - does it inevitably progress to Meniere's disease?.Acta Otolaryngol. 2008; 128: 304-308
- Relationship of vestibular aqueduct and inner ear pressure in Ménière's disease and the normal population.Laryngoscope. 2001; 111: 1625-1630
- The vestibular aqueduct sign: Magnetic resonance imaging can detect abnormalities in both ears of patients with unilateral Meniere's disease.J Neuroradiol. 2020; 47: 174-179
- Vestibular aqueduct measurements in the 45° Oblique (Pöschl) plane.Am J Neuroradiol. 2016; 37: 1331-1337
- Comparison of 45 degrees oblique reformats with axial reformats in CT evaluation of the vestibular aqueduct.Am J Neuroradiol. 2008; 29: 30-34
Published online: February 14, 2023
Accepted: January 31, 2023
Received: October 19, 2022
Publication stageIn Press Corrected Proof
© 2023 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.