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Title: [Analysis of the correlation between radiological and audiological features of patients with enlarged vestibular aqueduct].
Author: Wu SH, Ma XL.
Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2019 Oct 07; 54(10):734-740. PubMed ID: 31606985.
Abstract:
Objective: The radiological and audiological results of patients with hearing loss associated with enlarged vestibular aqueduct (EVA) were analyzed statistically to explore the association between them. Methods: In this retrospective study, we screened 64 patients (128 ears) with EVA diagnosed in the Department of Otorhinolaryngology, Shengjing Hospital of China Medical University from January 2012 to June 2016, who met the inclusion criteria and the exclusion criteria at the same time, including 37 males (74 ears) and 27 females (54 ears), aged from 6 months to 17 years, all of whom showed varying degrees of sensorineural hearing loss (SNHL). The imaging observations included the midpoint measurement (MP) and the operculum measurement(OP) of the temporal bone HRCT, the long signal area cross-sectional area (ES(L)), the short signal area cross-sectional area (ES(S)), as well as the largest total signal area cross-sectional area (ES(T)) of the endolymphatic sac(ES) of the cochlear MRI. The audiological observations included collecting detailed medical history and subjective and/or objective audiological examinations to determine the character and degree of hearing loss. According to the progress and changes of hearing loss, they were divided into hearing stability group (86 ears) and fluctuation/progression group (42 ears). SPSS22.0 statistical software was used to carry out statistical analysis of the imaging measurement results. Results: The sizes of MP and OP were smaller in the stable group than those in the fluctuating/progressive group, and the difference was statistically significant (P<0.05). For ES(L), ES(S) or ES(T), there was no significant difference between the stable group and the fluctuating/progressive group (P>0.05). For the 13 patients with asymmetric hearing loss, the sizes of MP, OP, ES(L), ES(S) or ES(T) were not significantly different between the mild side and the serious side (P>0.05). For the ears whose ES(L)/ES(S) was>2 or the ES(S)/ES(L) was>2, the proportion was not significantly different between the stable group and the fluctuating/progressive group (P>0.05). Conclusions: For patients with EVA,the smaller the enlarged vestibular aqueduct is,the more likely it is congenital severe sensorineural hearing loss. Patients with significantly enlarged vestibular aqueduct often exhibit volatility/progressive hearing loss. The degree of enlargement of the endolymphatic vessels and endolymphatic sac is not related to the degree of hearing loss. For EVA patients with asymmetric hearing loss, the mild or serious side of hearing loss is random, which is not affected by the degree of enlargement of the vestibular aqueduct and endolymphatic sac. The degree of hearing loss in patients with EVA is not related to the ratio of ES(L)/ES(S). 目的： 总结分析前庭导水管扩大（enlarged vestibular aqueduct，EVA）患者的影像学和听力学特征，探讨二者之间的相关性。 方法： 回顾性分析2012年1月至2016年6月中国医科大学附属盛京医院耳鼻咽喉头颈外科诊治的64例（128耳）EVA患者的临床资料，其中男37例（74耳）、女27例（54耳），年龄6个月~17岁，均表现为不同程度的感音神经性听力损失。影像学观察指标包括颞骨高分辨率CT半规管总脚到前庭水管外口1/2处直径（midpoint measurement，MP）和前庭水管外口直径（operculum measurement，OP），磁共振内耳水成像中内淋巴囊（endolymphatic sac，ES）长信号区截面积（ES(长)）、短信号区截面积（ES(短)）及总体最大截面积（ES(总)）。听力学检测包括详细病史收集和常规主客观听力学检查，以明确听力损失性质和程度。根据听力损失的进展及变化情况分为听力稳定组（43例，86耳）和波动/渐进组（21例，42耳）。采用SPSS 22.0软件对测量结果进行统计分析。 结果： 听力稳定组EVA患者的MP和OP均小于听力波动/渐进组，差异有统计学意义（P值均<0.05）。听力稳定组的ES(长)、ES(短)、ES(总)与听力波动/渐进组相比，差异均无统计学意义（P值均>0.05）。在13例非对称性听力损失患者中，听力损失较轻侧耳MP、OP、ES(长)、ES(短)、ES(总)与听力损失较重侧耳相比，差异均无统计学意义（P值均>0.05）。听力稳定组出现ES(长)/ES(短)>2及ES(短)/ES(长)>2的比例与听力波动/渐进组相比，差异无统计学意义（P>0.05）。 结论： 对于EVA患者，前庭导水管扩大的程度越轻，表现为先天性极重度感音神经性聋的可能性越大；明显扩大的前庭导水管常表现为波动性/渐进性听力损失。内淋巴管及内淋巴囊的扩大程度与听力损失程度无关。对于非对称性听力损失EVA患者，其听力损失轻重侧别是随机的，不受前庭导水管和内淋巴囊扩大程度的影响。EVA患者的听力损失程度与扩大的内淋巴管及内淋巴囊内不同信号物质的占比无关。.

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