Large vestibular aqueduct syndrome: a case study.
A 23-month-old female was referred for hearing aid fitting after failing newborn hearing screening and being diagnosed with significant hearing loss through subsequent diagnostic testing. Auditory brainstem response (ABR) and behavioral testing revealed a moderate-to-severe bilateral mixed hearing loss. Prior to the hearing aid evaluation, tympanostomy tubes had been placed bilaterally with little or no apparent change in hearing sensitivity. Initial testing during the hearing aid fitting confirmed earlier findings, but abnormal middle ear results were observed, requiring referral for additional otologic management. Following medical clearance, binaural digital programmable hearing aids were fit using Desired Sensation Level parameters. Behavioral testing and probe microphone measures showed significant improvements in audibility. Decrease in hearing sensitivity was observed six months following hearing aid fitting. Radiological studies, ordered due to the mixed component and decreased hearing sensitivity, revealed large vestibular aqueduct syndrome (LVAS). Based on the diagnosis of LVAS, a cochlear implant was placed on the right ear; almost immediate speech-language gains were observed.
Clark
Jackie L
JL
UT Dallas/Callier Center for Communication Disorders, 1966 Inwood Road, Dallas, TX 75235, USA. jclark@utdallas.edu
Roeser
Ross J
RJ
D002663:Child Language; D003054:Cochlear Implants; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006310:Hearing Aids; D006312:Hearing Loss, Bilateral / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation; D011379:Prognosis; D013577:Syndrome; D016896:Treatment Outcome; D014723:Vestibular Aqueduct / Q000002:abnormalities*