Audio-Vestibular Manifestations in Radiologically Confirmed Enlarged Vestibular Aqueduct in Congenital Non-Syndromic Sensorineural Hearing Loss in Egypt

Background: Enlarged vestibular aqueduct (EVA), the commonest radiological finding in children with sensorineural hearing loss is associated with variable auditory and vestibular symptoms.Aim of the Work: Is to determine vestibular findings in patients with EVA.Patients and Methods: 20 patients diagnosed as having sensorineural hearing loss and EVA as the study group, 20 healthy subjects matched for age and sex participated as the control group. Both groups underwent: Full history taking, General and neurological examination, Full ENT examination pure tone audiometry, tymanometry, high resolution computed tomography (HRCT), vestibular evoked myogenic potentials (VEMP), caloric test and computerized dynamic posturography.Results: EVA was bilateral in 14 patients and unilateral in 6 patients. The VEMP amplitude of wave p13-n23 was higher in ears with EVA and it correlated positively with its size, p13-n23 latencies did not differ significantly from the control group, caloric test showed absent response in 4 patients, unilateral weakness in 6 patients and normal results in 10 patients, there was no statistical significant difference regarding computerized dynamic posturography results. Conclusion: Results showed larger VEMP amplitude, which is indicative of third window lesion. Some patients showed Caloric test abnormalities which indicates a peripheral vestibular lesion. VEMP, caloric test and computerized dynamic posturography testing are effective in evaluating patients with EVA.