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Shen M, Xue S, Wei X, Chen B, Kong Y, Li Y. Characteristics of vestibular-evoked myogenic potentials in children with vestibular malformation and severe sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2024; 176:111781. [PMID: 38006708 DOI: 10.1016/j.ijporl.2023.111781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/16/2023] [Accepted: 11/05/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND With the increasing clinical focus on the safety of bilateral cochlear implantation (CI) and the potential risk of bilateral vestibular dysfunction, evaluating vestibular end-organ function in patients with vestibular malformations with accompanying abnormalities has been strongly recommended. OBJECTIVES To identify the vestibular-evoked myogenic potential (VEMP) values among children with sensorineural hearing loss (SNHL) with vestibular malformation and assess the effectiveness of VEMP testing for inner ear malformations (IEM) diagnosis. METHODS This study included 96 children (192 ears), including those with vestibular malformations (48 ears), large vestibular aqueduct syndrome (LVAS) (50 ears), and SNHL without IEM (94 ears; control group). All groups underwent ocular and cervical VEMP (oVEMP and cVEMP, respectively) testing. The response rates, VEMP parameters, and wave characteristics were compared. RESULTS The cVEMP response rates were 37.5 %, 64 %, and 58.51 % and the oVEMP response rates were 42.86 %, 78.95 %, and 77.27 % in the vestibular malformation, LVAS, and control groups, respectively, and significantly differed between groups (cVEMP: X2 = 18.228, P<0.001) (oVEMP: X2 = 7.528, P = 0.023). Significant inter-group differences were observed for the cVEMP and oVEMP latency and amplitude (P < 0.05). The LVAS group's waveform exhibited a prolonged latency and increased amplitude compared with that of the other groups. CONCLUSION Patients with SNHL were highly susceptible to otolith dysfunction, regardless of comorbid vestibular malformation presence. Measuring VEMPs is an effective and rapid evaluation technique for vestibular function and could provide a basis for vestibular rehabilitation training.
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Affiliation(s)
- Mengya Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shujin Xue
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xingmei Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Biao Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Kong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
| | - Yongxin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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Ay E, Gurses E, Aslan F, Gulhan B, Alniacik A, Duzova A, Bajin MD, Sennaroglu L, Genc GA, Ozaltin F, Topaloglu R. Hearing Loss Related to Gene Mutations in Distal Renal Tubular Acidosis. Audiol Neurootol 2023; 28:350-359. [PMID: 37121229 DOI: 10.1159/000529486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/30/2023] [Indexed: 05/02/2023] Open
Abstract
INTRODUCTION Distal renal tubular acidosis (dRTA) is a disease that may develop either primarily or secondarily, resulting from urinary acidification defects in distal tubules. Hearing loss may accompany primary forms of dRTA. This study aims to determine the characteristics of hearing loss due to different gene mutations in patients with dRTA. METHODS Behavioral and electrophysiological audiological evaluations were performed after otolaryngology examination in 21 patients with clinically diagnosed dRTA. Radiological imaging of the inner ear (n = 9) was conducted and results of genetic analyses using next-generation sequencing method (n = 16) were included. RESULTS Twenty-one patients with dRTA from 20 unrelated families, aged between 8 months and 33 years (median = 12, interquartile range = 20), participated. All patients with ATP6V1B1 mutations (n = 9) had different degrees of hearing loss. There was one patient with hearing loss in patients with ATP6V0A4 mutations (n = 6). One patient with the WDR72 mutation had normal hearing. Large vestibular aqueduct syndrome (LVAS) was detected in 6 (67%) of 9 patients whose radiological evaluation results were available. CONCLUSIONS LVAS is common in patients with dRTA and may influence the type and severity of hearing loss in these patients. The possibility of both congenital and late-onset and progressive hearing loss should be considered in dRTA patients. A regular audiological follow-up is essential for the early detection of a possible late-onset or progressive hearing loss in these patients.
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Affiliation(s)
- Ezgi Ay
- Department of Audiology, Baskent University Faculty of Health Sciences, Ankara, Turkey
| | - Emre Gurses
- Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey
| | - Filiz Aslan
- Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey
| | - Bora Gulhan
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Asuman Alniacik
- Department of Audiology, Baskent University Faculty of Health Sciences, Ankara, Turkey
| | - Ali Duzova
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Munir Demir Bajin
- Department of Ear Nose and Throat, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Ear Nose and Throat, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gulsum Aydan Genc
- Department of Audiology, Hacettepe University Faculty of Health Sciences, Ankara, Turkey
| | - Fatih Ozaltin
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Nephrogenetics Laboratory, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Zhu HY, Guo XT, Sun JQ, Sun JW. Characteristics of electrically evoked auditory brainstem response in children with large vestibular aqueduct syndrome after cochlear implantation. Acta Otolaryngol 2022; 142:52-56. [PMID: 34935592 DOI: 10.1080/00016489.2021.2012255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The vestibular aqueduct (VA) width may affect the auditory conduction pathway of large vestibular aqueduct syndrome (LVAS) children. OBJECTIVE Analyzing the electrically evoked auditory brainstem response (EABR) after cochlear implantation (CI) in severe to profound sensorineural hearing loss (SNHL) children with LVAS. MATERIALS AND METHODS Fifty-four children with SNHL who received CI were selected, including 21 children with LVAS and 33 children without inner ear malformations (IEMs). The VA width was measured in LVAS children. The post-operative EABRs were recorded in all children. RESULTS For the LVAS group, the VA width was positively correlated with wave III (eIII) latency of EABR at the No. 2 electrode (E2), E5, E8, and E11, the VA width was positively correlated with wave V (eV) latency of EABR at E2, E5, E8, and E11. Only the eV latency of E2 showed a significant difference between the two groups. CONCLUSION AND SIGNIFICANCE SNHL children with LVAS and no IEMs have similar conduction of the auditory pathway. In the LVAS group, the conduction of the auditory pathway becomes better with the decrease of VA width. Rational use of post-operative EABRs and the measurement of anatomical parameters can effectively assess the development of part auditory pathways in LVAS children, which may be helpful in predicting post-operative speech and hearing recovery.
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Affiliation(s)
- Han-yu Zhu
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiao-tao Guo
- Division of Life Sciences and Medicine, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Jia-qiang Sun
- Division of Life Sciences and Medicine, Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Jing-wu Sun
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
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Zhou C, Zou X, Peng C, Gao G, Guo Z. A novel genotyping technique for discriminating LVAS-associated high-frequency variants in SLC26A4 gene. AMB Express 2020; 10:166. [PMID: 32930899 PMCID: PMC7492351 DOI: 10.1186/s13568-020-01102-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022] Open
Abstract
An increasing number of biological and epidemiological evidence suggests that c.919-2A > G and c.2168A > G variants of solute carrier family 26, member 4 (SLC26A4) gene play a critical role in the development of large vestibular aqueduct syndrome (LVAS). In this study, we developed a rapid genotyping method for discriminating LVAS-associated high-frequency variants in SLC26A4 gene. The genotyping technique consists of 3' terminal exonuclease-resistant phosphorothioate-modified allele specific primer extension mediated by exo+ polymerase. In PCR amplification by Pfu polymerase, allelic specific primers perfectly matching wild type allele were extended while no specific products were yielded from primers targeting variant allele. Similarly, allelic specific primers perfectly matching variant allele were extended and no specific products were observed from primers targeting wild type allele. The clinical application of 3' terminal phosphorothioate-modified allele specific primer extension mediated by Pfu polymerase identified both homozygous for SLC26A4 gene c.919-2A > G variant in two patients clinically diagnosed as LVAS by temporal bone CT scan. The genetic results from this method are consistent with that of DNA sequencing. The data suggest that exo+ polymerase-mediated 3' terminal phosphorothioate-modified primer extension is reliable in the identification of SLC26A4 gene high-frequency variant prior to high-resolution CT scan. The method is extremely suitable for quickly molecular etiologic screening and early diagnosis and aggressive prevention therapy of LVAS.
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Affiliation(s)
- Chen Zhou
- Institute of Pharmacy and Pharmacology, University of South China, Hengyang, Hunan, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, Hunan, China
| | - Xiangman Zou
- Institute of Pharmacy and Pharmacology, University of South China, Hengyang, Hunan, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, Hunan, China
| | - Cuiying Peng
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, Hunan, China
| | - Guoqiang Gao
- The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Zifen Guo
- Institute of Pharmacy and Pharmacology, University of South China, Hengyang, Hunan, China. .,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang, Hunan, China.
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Hura N, Stewart M, Walsh J. Progression of hearing loss and cochlear implantation in large vestibular aqueduct syndrome. Int J Pediatr Otorhinolaryngol 2020; 135:110133. [PMID: 32480135 DOI: 10.1016/j.ijporl.2020.110133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Large vestibular aqueduct syndrome (LVAS) is a congenital inner ear malformation that commonly results in progressive sensorineural hearing loss (SNHL) and cochlear implantation (CI). Though LVAS accounts for approximately 15% of pediatric SNHL, little is known regarding the rate and severity of SNHL in these patients. We sought to characterize the timing of SNHL progression to CI in patients with LVAS. METHODS We performed a retrospective chart review at our institution from 2000 to 2018 using ICD-10 "large vestibular aqueduct syndrome," and through identifying patients with CI who had LVAS. Demographic, surgical, and audiometric data were collected. Theoretical CI candidacy was approximated using a pure tone average (PTA) HL threshold of 70 dB. RESULTS Of 103 patients, 96 had bilateral LVAS, and 7 had unilateral LVAS. Forty-one patients had bilateral implants, 52 had unilateral implants, and 10 were not implanted. The mean age at first implant was 8.62 years old [95%CI = 6.75,10.49], the mean age at second implant was 12.24 years old [95%CI = 8.33,16.15], and the mean time between implants was 4.37 years [95%CI = 3.02,5.73]. LVAS patients reached HL threshold of 70 dB at a mean age of 5.16 years old (SD = 3.04) for the "worse ear" and 9.08 years old (SD = 4.96) for the "better ear." CONCLUSIONS LVAS patients are a heterogenous population of patients, in which some may undergo progression of HL and some may not. Further, there may be a discrepancy in the timing between patients' theoretical CI candidacy and when they undergo CI. In order to optimize timing of CI, individual monitoring and close observation of LVAS patients is recommended.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., 6th Floor, 21287, Baltimore, MD, USA.
| | - Matthew Stewart
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., 6th Floor, 21287, Baltimore, MD, USA.
| | - Jonathan Walsh
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline St., 6th Floor, 21287, Baltimore, MD, USA.
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Zhang L, Wang J, Zhao F, Li Y. Inner ear pressure evaluation using wideband tympanometry in children with Large Vestibular Aqueduct Syndrome (LVAS): A pilot study. Int J Pediatr Otorhinolaryngol 2020; 128:109690. [PMID: 31678622 DOI: 10.1016/j.ijporl.2019.109690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/14/2019] [Accepted: 09/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate middle ear function in children with Large Vestibular Aqueduct Syndrome (LVAS) to explore the feasibility of measuring inner ear pressure using Wideband tympanometry (WBT). METHODS 13 young children with LVAS were recruited. WBT and other audiological measurements i.e., Auditory Steady State Response (ASSR), Auditory Brain Stem Response (ABR), and Distorted Product Otoacoustic Emissions (DPOAE) were performed. Absorbance under ambient and peak pressure were compared with normative data, and analyzed using a one sample t-test. RESULTS Average absorbance in children with LVAS was significantly lower than normative data under ambient pressure at 1000, 1189, 1296, 2000 Hz and 4000 Hz. Absorbance under peak pressure was also significantly lower at 707, 794, 917, 1000, 1189, 1297, 1498 and 2000 Hz. However, absorbance was higher than standard values above 4000 Hz under ambient and peak pressure. It was also higher under ambient pressure at frequencies below 500 Hz. CONCLUSION The special characteristics of middle ear function found in children with Large Vestibular Aqueduct Syndrome (LVAS) indicate that WBT offers a sensitive and non-invasive method to evaluate inner ear pressure indirectly.
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Affiliation(s)
- Lifang Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jie Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China; Beijing Engineering Research Center of Audiology Technology, Beijing, 100730, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, CF5 2YB, Wales, UK; Department of Hearing-Speech Sciences, Sun Yat-sen University, Guangzhou, 510520, China
| | - Yongxin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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Zhang Y, Chen Z, Zhang Y, Hu J, Wang J, Xu M, Zhang Q. Vestibular-evoked myogenic potentials in patients with large vestibular aqueduct syndrome. Acta Otolaryngol 2020; 140:40-45. [PMID: 31769324 DOI: 10.1080/00016489.2019.1687937] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: The vestibular function in patients of large vestibular aqueduct syndrome (LVAS) has not been clarified yet.Aims/objectives: To investigate the characteristic of otolithic organ in LVAS patients, we accessed their ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs).Material and methods: This study was carried out between 29 bilateral LVAS patients and 35 healthy controls. Parameters of VEMPs were analyzed.Result: In children patients, response rate for oVEMP was 93.47% and 86.95% for cVEMP. No statistical significance was found compared to their controls. In adult patients, response rate for oVEMP was 83.33% and 75% for cVEMP, which were statistically lower than their controls. In comparison to parameters of VEMPs, no statistical significance were found in children group. Amplitude of oVEMP was significantly higher and that of cVEMP was lower in LVAS adults. N1 latencies were significantly longer and P1 latencies were shorter in adult patients than in controls of cVEMP. Thresholds and N1-P1 intervals of VEMP were found no statistical significance in adult group.Conclusions and significance: We discovered a severer otolithic dysfunction in adults than in children patients. We recommend cVEMP a more effective and sensitive method than oVEMP in assessment of LAVS adult patients.
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Affiliation(s)
- Yan Zhang
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Zichen Chen
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Yuzhong Zhang
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Juan Hu
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Junli Wang
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Min Xu
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Qing Zhang
- Department of Otolaryngology – Head & Neck Surgery, Second Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an, China
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Bu H, Chen P, Wu ZG, Xu YL, Zou B, Su YP. [Imaging characteristics of patients with large vestibular aqueduct syndrome and its relationship with the acoustically evoked short latency negative response]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:561-565. [PMID: 31434367 DOI: 10.3760/cma.j.issn.1673-0860.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the imaging characteristics of large vestibular aqueduct syndrome (LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR), so as to provide reference for the diagnosis of LVAS. Methods: Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University, from October 2009 to December 2017 were retrospectively analyzed, including 117 males and 57 females, aged from 5 months to 47 years old, with the median age of 4 years and 4 months. ABR and imaging data of patients were collected. Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images, the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images. The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0. According to whether ASNR was detected in ABR, the above data were divided into two groups, and the differences of the above imaging measurements were compared by the Independent-Sample Test. Results: The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (x±s, the following was the same), and the outlet diameter was (3.07±0.99) mm on CT; the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39±1.37) mm, and the extraosseous parts was (2.50±2.18) mm on MRI. There was a correlation between the four measurements (P<0.05), among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760), and the remaining pairs were weakly correlated. ASNR was detected in 241 ears (72.16%,241/334) and undetected in 93 ears (27.84%, 93/334) of the 334 ears with LVAS. Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group, and the difference was statistically significant (t value was 2.814 and 2.754, P<0.05). There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups, and the difference was no statistically significant(t value was 0.101 and 0.683, P>0.05). Conclusions: There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients. There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac. The smaller the diameter of vestibular aqueduct, the lower the occurrence rate of ASNR.
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Affiliation(s)
- H Bu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - P Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Z G Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Y L Xu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - B Zou
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Y P Su
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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Connor SEJ, Dudau C, Pai I, Gaganasiou M. Is CT or MRI the optimal imaging investigation for the diagnosis of large vestibular aqueduct syndrome and large endolymphatic sac anomaly? Eur Arch Otorhinolaryngol 2019; 276:693-702. [PMID: 30635710 PMCID: PMC6411674 DOI: 10.1007/s00405-019-05279-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/02/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE We explored whether there was a difference between measurements obtained with CT and MRI for the diagnosis of large vestibular aqueduct syndrome or large endolymphatic sac anomaly, and whether this influenced diagnosis on the basis of previously published threshold values (Valvassori and Cincinnati). We also investigated whether isolated dilated extra-osseous endolymphatic sac occurred on MRI. Secondary objectives were to compare inter-observer reproducibility for the measurements, and to investigate any mismatch between the diagnoses using the different criteria. MATERIALS/METHODS Subjects diagnosed with large vestibular aqueduct syndrome or large endolymphatic sac anomalies were retrospectively analysed. For subjects with both CT and MRI available (n = 58), two independent observers measured the midpoint and operculum widths. For subjects with MRI (± CT) available (n = 84), extra-osseous sac widths were also measured. Results There was no significant difference between the width measurements obtained with CT versus MRI. CT alone diagnosed large vestibular aqueduct syndrome or large endolymphatic sac anomalies in 2/58 (Valvassori) and 4/58 (Cincinnati), whilst MRI alone diagnosed them in 2/58 (Valvassori). There was 93% CT/MRI diagnostic agreement using both criteria. Only 1/84 demonstrated isolated extra-osseous endolymphatic sac dilatation. The MRI-based LVAS/LESA diagnosis was less dependent on which criteria were used. Midpoint measurements are more reproducible between observers and between CT/MR imaging modalities. CONCLUSION Supplementing MRI with CT results in additional diagnoses using either criterion, however, there is no net increased diagnostic sensitivity for CT versus MRI when applying the Valvassori criteria. Isolated enlargement of the extra-osseous endolymphatic sac is rare.
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Affiliation(s)
- S E J Connor
- School of Biomedical Engineering and Imaging Sciences Clinical Academic Group, King's College, London, UK.
- Department of Radiology, Guy's and St. Thomas' Hospital, London, UK.
- Department of Neuroradiology, Ruskin Wing, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK.
| | - C Dudau
- Department of Radiology, Guy's and St. Thomas' Hospital, London, UK
- Department of Neuroradiology, Ruskin Wing, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - I Pai
- Department of Ear, Nose and Throat Surgery, Guy's and St Thomas' Hospital, London, UK
| | - M Gaganasiou
- 251 General and VA Air Force Hospital, Athens, Greece
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Zhou YJ, Wu YZ, Cong N, Yu J, Gu J, Wang J, Chi FL. Contrasting results of tests of peripheral vestibular function in patients with bilateral large vestibular aqueduct syndrome. Clin Neurophysiol 2017; 128:1513-1518. [PMID: 28667933 DOI: 10.1016/j.clinph.2017.05.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/16/2017] [Accepted: 05/16/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze and summarize the effect of bilateral large vestibular aqueducts in peripheral vestibular organ function. METHODS Eighteen patients with bilateral large vestibular aqueduct syndrome (LVAS; Study Group) and 18 healthy volunteers (Control Group) were investigated using audiometry, caloric test, sensory organization test (SOT), and vestibular-evoked myogenic potential (VEMP) tests. RESULTS All 18 patients (36 ears) exhibited sensorineural hearing loss. For cervical VEMP (cVEMP), the Study Group showed lower thresholds (Study Group vs. CONTROL GROUP 71.4vs. 75.3dBnHL; p=0.006), N1 latencies (24.1vs. 25.2ms; p=0.026) and shorter P1 (15.3vs. 16.6ms; p=0.003), and higher amplitudes (400.7vs. 247.2µV; p<0.001) than the Control Group. For ocular VEMP (oVEMP), the Study Group had lower thresholds (79.3vs. 81.8dBnHL; p=0.046) and higher amplitudes (40.6vs. 14.4µV; p<0.001) than the Control Group. Fourteen of 16 patients (87.5%) who completed caloric tests had abnormal results, and 10 of 18 patients (55.6%) exhibited abnormal results in SOTs. CONCLUSIONS The hyperfunction of vestibular test in otolithic organs and the hypofunction of vestibular test in semicircular canals, as well as the dysfunction in the balance test were demonstrated in patients with LVAS. SIGNIFICANCE Our findings can help clinicians gain a better understanding of the characteristics of vestibular organ function in patients with LVAS, which can facilitate optimal targeted treatment.
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Affiliation(s)
- Yu-Juan Zhou
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Yong-Zhen Wu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Ning Cong
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Jing Yu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Jun Gu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China
| | - Jing Wang
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China.
| | - Fang-Lu Chi
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China.
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El-Badry MM, Osman NM, Mohamed HM, Rafaat FM. Evaluation of the radiological criteria to diagnose large vestibular aqueduct syndrome. Int J Pediatr Otorhinolaryngol 2016; 81:84-91. [PMID: 26810296 DOI: 10.1016/j.ijporl.2015.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 12/17/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The main objective of the current work is to increase the sensitivity of the radiological diagnosis of the large vestibular aqueduct syndrome (LVAS). The specific aims were to compare between the two famous criteria to diagnose large vestibular aqueduct (LVA), (i.e., Valvassori and Cincinnati), to correlate between vestibular aqueduct (VA) measurements in the axial view and those in 45° oblique reformate in children with LVAS, and to define radiological criteria to diagnose LVA in the 45° oblique reformate. METHODS The study group included 61 children with LVAS according to Cincinnati criteria (greater than 0.9mm at the midpoint or greater than 1.9mm at the operculum in the axial view). All participants were subjected to full Audiological evaluation and CT scanning in axial plane. The axial data were then transferred to workstation for post-processing with 3D reformatting software (Baxara 3D) in order to obtain the 45° oblique reformates. VA measurements were done at 4 points: midpoint and operculum in both the axial plane and the 45° oblique reformate. RESULTS Only 81% of ears of children with LVAS (99 ears) fit Valvassori criterion (i.e., larger than 1.5mm at midpoint), while 19% (23 ears) of them were missed. There were statistically significant correlations among the diameters of the VA in the axial view (both in the midpoint and operculum) and their counterparts in the 45° oblique reformate. Values equal to or greater than 1.2mm in the midpoint and 1.3mm in the operculum are proposed to be the criteria to diagnose LVA in the 45° oblique reformate. Finally, no significant correlations were found between the degree of hearing loss and VA diameters at the axial or 45° oblique reformate. CONCLUSION Cincinnati criteria are more sensitive than Valvassori criterin in the diagnosis of LVAS. We recommend the application of Cincinnati criteria instead of Valvassori criteria in order not miss cases with LVAS. Measurement of VA in the 45° oblique reformate is a reliable method to diagnose LVA. Criteria to diagnose LVA in the 45° oblique reformate were proposed.
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Affiliation(s)
- Mohamed M El-Badry
- Otolaryngology Department, Audiology Unit, Minia University, Minia, Egypt.
| | - Nasr M Osman
- Radiology Department, Minia University, Minia, Egypt
| | | | - Fatma M Rafaat
- Otolaryngology Department, Audiology Unit, Minia University, Minia, Egypt
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Abstract
OBJECTIVES The aim of this study was to assess if large vestibular aqueduct syndrome (LVAS), with the increase in perilymphatic pressure, affects impedance changes over time with different types of Cochlear(®) implant electrode arrays Contour, Straight, and CI 422. To report speech perception outcomes for these cochlear implant recipients. METHODS Retrospective case review of impedance levels and categories of auditory performance. Impedance data were collected at switch on, 1 month, 3, 6, 12, and 24 months after cochlear implantation and compared with control (non-LVAS cochlear implant recipient) data for each array type. Forty-seven patients with exclusive LVAS and no other vestibulocochlear abnormalities or other identifiable cause of deafness were eligible for inclusion in the study. RESULTS In LVAS patients, there was a significant difference in impedance between the three types of device (P < 0.0001). Time since switch on was associated with a decrease in impedance for all three devices (P < 0.0001). The mean impedance reduced between switch on and 1 month and remained relatively constant thereafter. Sound variation with softening of sounds was seen in four CI 422 (Straight Research Array) recipients due to ongoing fluctuations in electrode compliance. DISCUSSION For all three array types, there was no significant difference in the mean impedance between the LVAS patients and controls over the first 12 months. In keeping with previous studies cochlear implant recipients with LVAS hear very well through the cochlear implant.
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