Comparison of the Vestibular Aqueduct between Acute Low-Tone Sensorineural Hearing Loss and Ménière’s Disease

Abstract

Objectives:

Most acute low-tone sensorineural hearing loss without vertigo (ALHL) improves over time; however, some cases develop into typical Ménière’s disease (MD), suggesting an association between ALHL and MD. This study aimed to investigate associations between ALHL and MD from the perspective of development of the vestibular aqueduct.

Methods:

Prospective case-control study at a tertiary referral center. In 51 patients with unilateral ALHL (15 males, 36 females; mean age, 52.3 years), 35 patients with unilateral MD (14 males, 21 females; mean age, 43.1 years) and 11 healthy controls (11 males; mean age, 33.3 years), length of the external aperture of the vestibular aqueduct (EAVA) was measured on 3-dimensional computed tomography. Results were then compared among ALHL patients, MD patients, and controls.

Results:

On the affected side, mean length of the EAVA was 5.8 ± 2.7 mm in ALHL patients, 4.3 ± 2.0 mm in MD patients, and 6.5 ± 1.5 mm in controls. The EAVA was significantly shorter in MD than in ALHL or controls. Among ALHL patients, length of the EAVA was significantly shorter in patients with recurrence (4.5 ± 1.9 mm) than in those without recurrence (6.4 ± 2.5 mm).

Conclusions:

Hypoplasia of the endolymphatic sac may represent a predisposing factor for recurrence of ALHL and/or MD, as development of the endolymphatic sac is known to correlate with length of the EAVA.