Neuro-otologic findings in unilateral isolated narrow internal auditory meatus.

OBJECTIVE

To report neuro-otologic findings concerning the four nerves in the internal auditory meatus (IAM) in patients with isolated congenitally narrow IAM and explore the implications regarding ontogeny of the nerves in the IAM.

DESIGN

Retrospective case series study.

SETTING

University hospital.

SUBJECTS

Five consecutive patients between 1997 and 2002 with unilateral isolated narrow IAM demonstrated by high-resolution computed tomography whose chief complaint was hearing loss (1 male and 4 females, 4 right sides and 1 left; age range 5-37 years, mean 20 years; IAM diameter at the porus: 26-33% of that on the normal side).

MAIN OUTCOME MEASURES

Functional studies concerning the VIIth cranial nerve and the three branches of the VIIIth cranial nerve.

RESULTS

In all ears, auditory brain stem responses were absent, the speech discrimination score was 0%, and otoacoustic emissions were absent or markedly reduced compared with those on the normal side. Caloric responses were absent in two ears, reduced in two ears, and normal in one ear. Galvanic body sway tests showed no responses in the two ears in which caloric responses were absent. Inferior vestibular nerve function was estimated as normal in all ears on the basis of vestibular evoked myogenic potential recordings. Facial nerve functions were normal in all patients.

CONCLUSIONS

In isolated congenital stenosis of IAM, dysfunction of each nerve in the IAM can occur independently. In the ontogeny of the VIIIth cranial nerve, the cochlear and superior vestibular nerves tended to be involved together, whereas the cochlear and inferior vestibular nerves appeared independent of each other.