Investigation of Third Window Symptoms in Patients With Enlarged Vestibular Aqueduct: A Pilot Study

Objective: To assess if patients with enlarged vestibular aqueduct (EVA) experience symptoms characteristic of other third mobile window disorders such as superior semicircular canal dehiscence syndrome (SCDS).

Study design: Cross-sectional study.

Setting: Tertiary care center.

Methods: Adult and pediatric patients with EVA were screened. Patients with additional middle or inner ear pathology were excluded. The included patients and parents of pediatric patients were asked to complete a survey regarding symptoms, including autophony, hyperacusis, and sound- and pressure induced dizziness.

Results: Of the 121 patients who met inclusion criteria, 36 patients and parents completed the questionnaire (15 children and 21 adults). Adult EVA patients appeared to suffer from similar rates of hyperacusis (67%), autophony (52%), pressure induced dizziness (38%), ear fullness (62%), and spontaneous dizziness or vertigo (67%) compared to reported rates among SCDS patients. Children with EVA also appeared to have similar rates of hyperacusis (67%), ear fullness (47%), and spontaneous dizziness or vertigo (40%), while pressure induced dizziness (13%) and autophony (20%) seem less common in children and sound induced dizziness appears less common in both children and adults (13% and 14% respectively).

Conclusion: This is the first study investigating the prevalence of typical third-window symptoms in patients with EVA. We found an overlap in the prevalence of several specific and nonspecific third window symptoms for patients with EVA and SCDS.