title: Vestibular Dysfunction in Patients with Enlarged Vestibular Aqueduct.
abstract: OBJECTIVE
  Enlarged vestibular aqueduct (EVA) is the most common inner ear malformation. While a strong correlative relationship between EVA and hearing loss is well established, its association with vestibular dysfunction is less well understood. In this study, we examine the effects of EVA on the vestibular system in patients with EVA.
  
  
  METHODS
  Prospective, cross-sectional study of a cohort ascertained between 1999 and 2013.
  
  
  METHODS
  National Institutes of Health Clinical Center, a federal biomedical research facility.
  
  
  METHODS
  In total, 106 patients with unilateral or bilateral EVA, defined as a midpoint diameter greater than 1.5 mm, were referred or self-referred to participate in a study of the clinical and molecular aspects of EVA. Clinical history was ascertained with respect to the presence or absence of various vestibular signs and symptoms and history of head trauma. Videonystagmography (VNG), cervical vestibular evoked myogenic potential (cVEMP), and rotational vestibular testing (RVT) were performed to assess the vestibular function.
  
  
  RESULTS
  Of the patients with EVA, 45% had vestibular signs and symptoms, and 44% of tested patients had abnormal VNG test results. An increased number of vestibular signs and symptoms was correlated with the presence of bilateral EVA (P = .008) and a history of head injury (P < .001). Abnormal VNG results also correlated with a history of head injury (P = .018).
  
  
  CONCLUSIONS
  Vestibular dysfunction is common in patients with EVA. However, not all patients with vestibular signs and symptoms have abnormal vestibular test results. Clinicians should be aware of the high prevalence of vestibular dysfunction in patients with EVA.
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Chris K
authors.initials: CK
authors.lastname: Zalewski
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Wade W
authors.initials: WW
authors.lastname: Chien
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: King
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Muskett
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Baron
authors.affiliation: Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Butman
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA griffita@nidcd.nih.gov.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Griffith
authors.affiliation: National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Brewer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014723:Vestibular Aqueduct / Q000002:abnormalities*; D015837:Vestibular Diseases / Q000150:complications*
keywords: EVA; LVAS; RVT; VEMP; VNG; dizziness; enlarged vestibular aqueduct; hearing loss; vertigo; vestibular dysfunction