Saliba Issam, Gingras-Charland Marie-Eve, St-Cyr Karine, Décarie Jean-Claude
Department of Pediatric Otolaryngology - Head and Neck Surgery, Sainte-Justine University Hospital Center (CHU SJ), University of Montreal, Montreal, Quebec, Canada.
Int J Pediatr Otorhinolaryngol. 2012 Apr;76(4):492-9. doi: 10.1016/j.ijporl.2012.01.004. Epub 2012 Jan 26.
To assess the correlation between the enlarged vestibular aqueduct (EVA) diameter and (1) the hearing loss level (mild, moderate, severe and profound and (2) the hearing evolution. The secondary objective was to obtain measurement limits on the coronal plane of the temporal bone CT scan for the diagnosis of EVA.
Retrospective study in a tertiary pediatric center. Mastoid CT scans were reviewed to measure the VA diameter at its midpoint and operculum on axial and coronal planes in a pathologic and normal population. We used their serial audiograms to assess the evolution of hearing.
101 EVA was identified out of 1812 temporal bones CT scan from our radiologic database in 8 years. Bone conduction was stable after a mean follow-up of 40.9 ± 32.9 months. PTA has been the most affected in time by the EVA (p=0.006). No correlation was identified between impedancemetry and the diameter of the EVA. On the diagnostic audiogram, 61% of hearing loss were in the mild and moderate hearing levels; at the end of the follow-up 64% of hearing loss are still in the mild and moderate hearing levels. The cut-off values for the coronal midpoint and operculum planes on the CT scan to diagnose an EVA are 2.4 mm and 4.34 mm respectively.
Conductive or mixed hearing loss might be the first manifestation of EVA. Coronal CT scan cuts can provide additional information to evaluate EVA especially when axial cuts are not conclusive.
评估扩大的前庭导水管（EVA）直径与（1）听力损失程度（轻度、中度、重度和极重度）以及（2）听力演变之间的相关性。次要目的是获取颞骨CT扫描冠状面上用于诊断EVA的测量界限。
在一家三级儿科中心进行回顾性研究。对乳突CT扫描进行评估，以测量病理人群和正常人群在轴位和冠状面上前庭导水管中点和总脚处的直径。我们使用他们的系列听力图来评估听力演变。
在8年中，从我们的放射学数据库的1812例颞骨CT扫描中识别出101例EVA。平均随访40.9±32.9个月后骨传导稳定。纯音平均听阈受EVA影响最大（p=0.006）。未发现声阻抗测量与EVA直径之间存在相关性。在诊断性听力图上，61%的听力损失为轻度和中度听力水平；随访结束时，64%的听力损失仍为轻度和中度听力水平。CT扫描上用于诊断EVA的冠状面中点和总脚平面的截断值分别为2.4mm和4.34mm。
传导性或混合性听力损失可能是EVA的首发表现。冠状CT扫描层面可提供额外信息以评估EVA，尤其是在轴位层面诊断不明确时。
