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The relationship between vestibular aqueduct diameter and sensorineural hearing loss is linear: a review and meta-analysis of large case series

Published online by Cambridge University Press:  11 September 2012

C R Spencer
C R Spencer*
Affiliation:
Department of Head and Neck Surgery, St George's Hospital, London, UK
*
Address for correspondence: Mr C R Spencer, Thomas Tatum Head and Neck Unit, St George's Healthcare NHS Trust, Blackshaw Road, London SW17 0QT, UK Fax: +44 (0)20 8725 3081 E-mail: drchekaspencer@doctors.org.uk
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Abstract

Introduction:

Inner ear homeostasis is dependent on the vestibular aqueduct and its content, the endolymphatic duct. Narrow and enlarged vestibular aqueducts have both been associated with hearing loss in Ménière's and large vestibular aqueduct syndromes. This review investigated the correlation between vestibular aqueduct diameter and pure tone average, and the effect of measurement site (i.e. the midpoint or the external aperture).

Materials and methods:

A systematic review of the literature and meta-analysis of large case series published on the Allied and Complementary Medicine, British Nursing Index, Cumulative Index to Nursing and Allied Health, Embase, Health Business Elite, Health Management Information Consortium, Medline, PsycInfo and PubMed databases. References and personal books were also scrutinised.

Results:

A linear relationship between vestibular aqueduct diameter and hearing loss was observed, with a projected increase of 6 dBHL per unit of vestibular aqueduct diameter (95 per cent confidence interval, 2–10; p = 0.003). This relationship was independent of measurement site.

Discussion:

This dose-dependent or linear relationship supports the role of flow and/or pressure change as aetiological factors in the pathogenesis of hearing loss, as per Poiseuille's law. This aetiological association is strengthened by the fact that the observed relationship is independent of measurement site.

Keywords

Skull BaseOtologyPaediatric Ears/OtologyEndolymph FlowPressure
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1086 - 1090
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented at: the ENT UK and Otorhinolaryngological Research Society Joint Annual Scientific Meetings, 10 September 2010, Birmingham; the National Scientific Meeting on Skull Base Pathology of the British Society of Oral and Maxillofacial Pathology, 28–29 April 2010, London; the National Academic Conference of the Association of Surgeons In Training, 12–14 March 2010, Hull; and the Fourth Alcock's Society Academic Meeting, 4 September 2009, London, UK

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