2000 Volume 43 Issue 2 Pages 169-174
Fourteen cases (28 ears; female-to-male ratio 1:1) of hearing loss with the large vestibular aqueducts were followed for more than 3 years. After follow-up of 3 to 16 years (mean: 8.7 years), progressive hearing loss more than 10dB was observed in only 6 ears (21%) and the rate of hearing loss progression was 0.6dB per year, but 25 ears (85%) demonstrated acute hearing drops. The hearing in 11 ears (39%) fluctuated (more than 4 episodes of hearing drop) but almost all drops recovered after conservative therapy including administration of corticosteroids and/or prostagrandin E1 and/or hyperbaric oxygen therapy. The ears with progressive or fluctuating hearing loss were frequently associated with vestibular symptoms at hearing drop, and developed these attacks without triggers such as minor head trauma. We suggest that the large vestibular aqueduct includes some subcategories such as stable or fragile inner ear. Acute hearing drop with vertigo without trigger in a patient with the large vestibular aqueducts should be treated carefully.
