The large vestibular aqueduct syndrome (LVAS) is commonly found when presurgical computed tomography is performed in advance of cochlear implantation. We present data on two patients with LVAS, in whom computed tomography (CT) and magnetic resonance imaging (MRI) was performed. Cochlear implantation when these malformations are present may be complicated by an intraoperative gusher, but it appears to be safe and produces a favorable outcome.