Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S234-S235
DOI: 10.1055/s-0042-1746486
Abstracts | DGHNOKHC
Imaging / Sonography: Ear / Temporal bone

Update on the radiological diagnosis of enlarged vestibular aqueduct (EVA) – therapeutic and prognostic implications

Nora M Weiss
1   Klinik für Hals-Nasen-Ohrenheilkunde der Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum, Bochum
,
Tabita Breitsprecher
1   Klinik für Hals-Nasen-Ohrenheilkunde der Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum, Bochum
,
Alexander Pscheidl
2   Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum Dortmund, Dortmund
,
David Bächinger
3   Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich, SchweizZürich, Switzerland
,
Stefan Volkenstein
1   Klinik für Hals-Nasen-Ohrenheilkunde der Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum, Bochum
,
Stefan Dazert
1   Klinik für Hals-Nasen-Ohrenheilkunde der Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum, Bochum
,
Sönke Langner
4   Institut für Diagnostische and Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Rostock
,
Robert Mlynski
5   Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, “Otto Körner”, Universitätsmedizin Rostock, Rostock
,
Peter Roland
6   Department of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA, Dallas, United States
,
Anandhan Dhanasingh
7   MEDEL Elektromedizinische Geräte InnsbruckInnsbruck, Austria
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    Objectives Enlarged vestibular aqueduct (EVA) is a common finding associated with inner ear malformation (IEM). Furthermore, EVA can indicate the presence of syndromic diseases. However, uniform radiologic definitions for EVA are missing. This study evaluates VA-volume in different types of IEM and compares 3D-reconstructed VA-volume to 2D-measurements.

    Methods 98 CT datasets from temporal bones were analyzed (56 with IEM; [cochlear hypoplasia (CH;n=18), incomplete partition type I (IPI;n=12) and type II (IPII;n=11) and EVA (n=15)]; 42 controls). VA-diameter was measured in axial images. VA-volume was analyzed by 3D-reconstruction. Inter-rater-reliability (IRR) was assessed using the intra-class-correlation-coefficient (ICC).

    Results Significant differences in VA-volume between patients with EVA and controls (p < 0.0001) as well as between IPII and controls (p<0.0001) were found. VA diameter at the midpoint (VA midpoint) as well as at the operculum ( VA operculum) and VA volume showed weak to very strong correlations in IPI (VA midpoint: r=0.78, VA operculum: r=0.91), in CH (VA midpoint : r=0.59, VA operculum: r=0.61), in EVA (VA midpoint: r=0.55, VA operculum: r=0.66) and in controls (VA midpoint : r=0.36, VA operculum : r=0.42). Highest IRR was found for VA volume (ICC=0.90)

    Conclusion VA diameter is an unreliable estimate of VA volume since (1.) measurement of VA diameter does not correlate well with VA volume and (2.) VA diameter shows a lower IRR than VA volume. VA volumetry provides new complementary information for the diagnosis of EVA and thus the clinical prognosis. The presented data suggest VA-volumetry to improve the diagnostic workup of isolated EVA and IEM. Consequently, an implementation into the diagnostic tools is recommended.


     

    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publication History

    Article published online:
    24 May 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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