Retrospective Analysis of the Association of a Small Vestibular Aqueduct with Cochleovestibular Symptoms in a Large, Single-Center Cohort Undergoing CT

BACKGROUND AND PURPOSE: Temporal bones in some patients with M & eacute;ni & egrave;re disease have demonstrated small vestibular aqueducts; however, the prevalence and clinical importance of small vestibular aqueducts remain unclear in patients without M & eacute;ni & egrave;re disease. This study correlates the presence of a small vestibular aqueduct with cochleovestibular symptoms. MATERIALS AND METHODS: Consecutive temporal bone CTs in adults from January to December 2020 were reviewed. The midpoint vestibular aqueduct size in the 45 degrees-oblique Poschl view was measured by 2 reviewers independently in 684 patients (1346 ears). Retrospective chart review for the clinical diagnosis of M & eacute;ni & egrave;re disease, the presence of cochleovestibular symptoms, and indications for CT was performed. RESULTS: Fifty-two of 684 patients (7.6% of patients, 62/1346 ears) had small vestibular aqueducts. Twelve patients (15/1346 ears) had M & eacute;ni & egrave;re disease. Five of 12 patients with M & eacute;ni & egrave;re disease (5 ears) had a small vestibular aqueduct. There was a significant correlation between a small vestibular aqueduct and M & eacute;ni & egrave;re disease (P , .001). There was no statistical difference between the small vestibular aqueduct cohort and the cohort with normal vestibular aqueducts (0.3-0.7 mm) regarding tinnitus (P = .06), hearing loss (P = .88), vertigo (P = .26), dizziness (P = .83), and aural fullness (P = .61). CONCLUSIONS: While patients with M & eacute;ni & egrave;re disease were proportionately more likely to have a small vestibular aqueduct than patients without M & eacute;ni & egrave;re disease, the small vestibular aqueduct was more frequently seen in patients without M & eacute;ni & egrave;re disease and had no correlation with hearing loss, vertigo, dizziness, or aural fullness. We suggest that the finding of a small vestibular aqueduct on CT could be reported by radiologists as a possible finding in M & eacute;ni & egrave;re disease, but it remains of uncertain, and potentially unlikely, clinical importance in the absence of symptoms of M & eacute;ni & egrave;re disease.

Automated summary

Small vestibular aqueducts are more frequently seen in patients without Ménière disease and have no correlation with symptoms such as hearing loss and vertigo.