Insidious Cases of Enlarged Vestibular Aqueduct (EVA) Syndrome Resembling Otosclerosis: Clinical Features for Differential Diagnosis and the Role of High-Resolution Computed Tomography in the Pre-Operative Setting.

IF 2.1 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Audiology Research Pub Date : 2024-06-27 DOI:10.3390/audiolres14040050

Giovanni Motta, Salvatore Allosso, Ludovica Castagna, Ghita Trifuoggi, Tonia Di Meglio, Domenico Testa, Massimo Mesolella, Gaetano Motta

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引用次数: 0

Abstract

Background: Enlarged vestibular aqueduct (EVA) syndrome can mimic otosclerosis in adults, presenting with an air-bone gap (ABG) and even absent stapedial reflexes. The ABG in inner-ear disorders is currently the object of several authors' studies and seems to be related to a third mobile window (TMW) phenomenon. This can lead to misdiagnosis and inappropriate treatment. Given that it would be inappropriate and harmful to perform CT scans in all patients with a clinical diagnosis of otosclerosis, this study aims to highlight some clinical features useful for the differential diagnosis between otosclerosis and these rare cases of EVA presenting with an ABG, thus enabling the identification of suspected cases to be tested with CT scans.

Methods: Between April and May 2024, a narrative review was conducted focusing on the differential diagnosis between some rare cases of EVA and otosclerosis. Clinical, audiological, and radiologic features of both conditions were investigated.

Results: This review demonstrates the diagnostic challenge in differentiating atypical cases of EVA from otosclerosis in a subset of patients. Clinical and audiological features are important for differential diagnosis, but may not always be sufficient. Therefore, high-resolution computed tomography (HRCT) of the temporal bone plays a pivotal role in definitive diagnosis.

Conclusions: In some specific cases, pre-operative imaging assessment using HRCT emerges as an essential tool for differentiating these two conditions and avoiding unnecessary stapes surgery.

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类似耳硬化症的前庭导水管扩大（EVA）综合征疑难病例：鉴别诊断的临床特征及高分辨率计算机断层扫描在术前设置中的作用。

背景：前庭导水管扩大（EVA）综合征可模拟成人耳硬化症，表现为气骨间隙（ABG），甚至镫骨反射消失。内耳疾病的 ABG 目前是多位学者研究的对象，似乎与第三移动窗（TMW）现象有关。这可能会导致误诊和治疗不当。鉴于对所有临床诊断为耳硬化症的患者进行 CT 扫描是不恰当且有害的，本研究旨在强调一些临床特征，这些特征有助于对耳硬化症和这些出现 ABG 的罕见 EVA 病例进行鉴别诊断，从而确定疑似病例并进行 CT 扫描检测：方法：2024 年 4 月至 5 月期间，对一些罕见的 EVA 病例与耳硬化症之间的鉴别诊断进行了叙述性综述。研究了这两种疾病的临床、听力学和放射学特征：结果：这篇综述显示了将一部分患者的非典型 EVA 病例与耳硬化症进行鉴别诊断所面临的挑战。临床和听力学特征对鉴别诊断很重要，但不一定足够。因此，颞骨的高分辨率计算机断层扫描（HRCT）在明确诊断中起着关键作用：结论：在某些特殊病例中，使用高分辨率计算机断层扫描进行术前成像评估是区分这两种疾病并避免不必要的镫骨手术的重要工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Audiology Research AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-

CiteScore

2.30

自引率

23.50%

发文量

审稿时长

11 weeks

期刊介绍： The mission of Audiology Research is to publish contemporary, ethical, clinically relevant scientific researches related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear that can be used by clinicians, scientists and specialists to improve understanding and treatment of patients with audiological and neurotological disorders.