Enlarged vestibular aqueduct in pediatric sensorineural hearing loss

OBJECTIVE: Comparison of the Cincinnati criteria (midpoint >0.9 mm or operculum >1.9 mm) to the Valvassori criterion (midpoint > or =1.5 mm) for enlarged vestibular aqueduct (EVA) in pediatric cochlear implant patients. STUDY DESIGN: Cohort study. SUBJECTS: One hundred thirty pediatric cochlear implant recipients. METHODS: We reviewed temporal bone CT scans to measure the vestibular aqueduct midpoint and opercular width. RESULTS: The Cincinnati criteria identified 44 percent of patients with EVA versus 16 percent with the Valvassori criterion (P < 0.01). Of those with EVA, 45 percent were unilateral and 55 percent were bilateral using Cincinnati criteria; 64 percent were unilateral and 36 percent bilateral using Valvassori criterion (P < 0.01). The Cincinnati criteria diagnosed 70 ears with EVA classified as normal using the Valvassori criterion (P < 0.01); 59 lacked another medical explanation for their hearing loss. CONCLUSION: The Cincinnati criteria identified a large percentage of pediatric cochlear implant patients with EVA who might otherwise have no known etiology for their deafness.