Effect of High Jugular Bulb on the Hearing Loss Characteristics in Patients With LVAS: A Pilot Study.

Arthur Benjamin Kwesi,Yu Sun,Chenlu Wang,Yonghua Wang,Jintao Yu,Xiaohui Yan,Wendi Shi,Fengyi Chuang

doi:10.3389/fcell.2021.743463

Abstract

ObjectiveBoth large vestibular aqueduct syndrome (LVAS) and high jugular bulb (HJB) are regarded as abnormalities commonly seen on the temporal bone CT. High jugular bulb has been found to erode the vestibular aqueduct, and there are several studies on jugular bulb vestibular aqueduct dehiscence. However, there is no study that specifically reports LVAS with concurrent HJB and its hearing loss relatedness. This study presents the pure tone audiometry differences between LVAS with HJB, and LVAS without HJB.MethodsThis was a case control study involving 36 bilateral LVAS with concurrent unilateral HJB patients, total of 72 ears. Intra-person comparison was done, by dividing ears into two groups: the case group, 36 ears (LVAS with HJB); and the control group, 36 ears (LVAS without HJB). Air conduction thresholds (250–4000 Hz), bone conduction thresholds (250–1000 Hz), and air bone gap (250–1000 Hz) were analyzed and compared between groups.ResultThere were statistically significant differences in AC thresholds at 250, 500, 2000, and 4000 Hz between the groups, p < 0.05. But there was no statistical significant difference at 1000 Hz, p > 0.05. There were statistical significant differences in BC thresholds at 250 and 500 Hz, p < 0.05, but there was no statistical difference at 1000 Hz. There were no significant differences in air bone gap at 250, 500, and 1000 Hz between the two groups.ConclusionLVAS with concurrent HJB was found to have higher air conduction thresholds, especially at 250, 500, 2000, and 4000 Hz. Bone conduction thresholds were higher at 250 and 500 Hz. Air bone gap at 250, 500, and 1000 Hz, were not significantly higher in LVAS with concurrent HJB.

Highlights

Large vestibular aqueduct syndrome (LVAS) is defined as the enlargement of the narrow bony canals, which extends from the vestibule into the skull
There are no previous studies in literature about the large vestibular aqueduct syndrome with high jugular bulb and its hearing loss relatedness
The purpose was to ascertain the audiological characteristics of vestibular aqueduct syndrome with concurrent high jugular bulb by finding out the differences in air conduction thresholds, bone conduction thresholds, and air bone gap between LVAS with High jugular bulb (HJB) and LVAS without HJB

Summary

Introduction

Large vestibular aqueduct syndrome (LVAS) is defined as the enlargement of the narrow bony canals (aqueducts), which extends from the vestibule into the skull. Large vestibular aqueduct syndrome with concurrent high jugular bulb has been observed clinically in patients having hearing loss. There are no previous studies in literature about the large vestibular aqueduct syndrome with high jugular bulb and its hearing loss relatedness. Previous studies on high jugular bulb revealed worse hearing thresholds and progressive hearing in the affected ears of patients with bilateral hearing loss (Tsunoda, 2000; Sasindran et al, 2014). The purpose was to ascertain the audiological characteristics of vestibular aqueduct syndrome with concurrent high jugular bulb by finding out the differences in air conduction thresholds, bone conduction thresholds, and air bone gap between LVAS with HJB and LVAS without HJB. The findings of this study are intended to help ear and hearing health professionals to understand the differences that exist among LVAS patients, in order to guide their diagnosis, counseling, and hearing management, as well as to guide future research on LVAS and HJB

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