Progressive Hearing Loss and Head Trauma in Enlarged Vestibular Aqueduct: A Systematic Review and Meta-analysis.

Abstract

Enlarged vestibular aqueduct is the most common radiographically identified cause of congenital sensorineural hearing loss and is frequently progressive. Imaging is often ordered during the workup of children with congenital sensorineural hearing loss in part to identify enlarged vestibular aqueduct given concern for progression with head trauma. However, this association has not been systematically evaluated. We aimed to determine the rate of progression and association with head trauma in individuals with enlarged vestibular aqueduct. Systematic review of primary studies identified through PubMed, Embase, Cochrane, and Web of Science. Meta-analysis was performed on patient-level data describing enlarged vestibular aqueduct, progressive sensorineural hearing loss, and head trauma extracted from articles identified on systematic review according to PRISMA guidelines. Twenty-three studies (1115 ears with enlarged vestibular aqueduct) met inclusion criteria. Progressive sensorineural hearing loss was found in 39.6% of ears, with trauma-associated progression in 12%. Limited case-control data show no difference in the incidence of progression between patients with and without head trauma. Long-term progressive sensorineural hearing loss is common in enlarged vestibular aqueduct, but its association with head trauma is not strongly supported.