Sex-specific enlarged vestibular aqueduct morphology and audiometry

Area of Science:

• Pediatric Otolaryngology
• Audiology
• Medical Imaging

Background:

• Enlargement of the vestibular aqueduct (EVA) is a frequent congenital anomaly associated with pediatric sensorineural or mixed hearing loss.
• The correlation between vestibular aqueduct (VA) morphology and hearing loss, particularly concerning sex-based differences, remains incompletely understood.

Purpose of the Study:

• To investigate the relationship between sex, vestibular aqueduct (VA) morphology, and hearing thresholds in pediatric patients.
• To determine if sex influences the degree of EVA and its impact on hearing loss.

Main Methods:

• Retrospective, longitudinal study of 47 pediatric patients with hearing loss and CT scans.
• EVA criteria confirmed by measuring VA midpoint and operculum widths.
• Audiometric assessment included pure-tone average and frequency-specific hearing thresholds.

Main Results:

• Female patients exhibited significantly larger average operculum (3.25 mm vs. 2.70 mm) and VA midpoint (2.80 mm vs. 1.90 mm) widths compared to males (p < 0.01 for both).
• Despite greater EVA enlargement in females, male patients had significantly worse pure-tone average hearing thresholds (17.6 dB worse, 95% CI: 3.8 to 31.3 dB) after adjusting for morphology.

Conclusions:

• While females present with more pronounced enlargement of the vestibular aqueduct, this morphological difference does not translate to a difference in hearing loss severity.
• Current criteria for EVA diagnosis may require re-evaluation.
• Further research into sex-based morphological and audiometric variations is crucial for managing patient and clinician expectations.