Multi-detector computed tomography (MDCT) and audiological criteria to diagnose large vestibular aqueduct syndromeI

The purpose of this study was to compare between Valvassori and Cincinnati criteria and to correlate between vestibular aqueduct measurements made in axial plane with those made in 45 degree oblique reformats. Patients and methods: The study group included 61 children with LVAS. All participants were subjected to full Audiological evaluation and MDCT scanning in axial plane. The axial data were transferred to workstation for post-processing with multiplanar reformatting software in order to obtain the 45 degree oblique reformats. Vestibular aqueduct measurements were made at 4 points: midpoint and operculum in both the axial plane and 45 degree oblique reformats. Results: 100% (122 ears) were diagnosed according to Cincinnati criteria, while 81% (99 ears) of children with LVAS fit Valvassori criterion, and 19% were (23 ears) missed. There were statistically significant correlations among the diameters of the VA in the axial plane (midpoint and operculum) and their counterparts in the 45 degree oblique reformats. Values equal to or greater than 1.2 mm in the midpoint and 1.3 mm in the operculum are proposed to be the criteria to diagnose LVA in the 45 degree oblique reformats. Conclusion: Cincinnati criteria are more sensitive than Valvassori criteria in the diagnosis of LVAS