Wideband Acoustic Immittance Patterns in Enlarged Vestibular Aqueduct: A Systematic Review and Meta-Analysis
-
Alireza Sharifi
,
Raha Zamani
,
Jacob R. Brodsky
,
Maryam Yaghoubi Hamgini
,
Samad Samadizadeh
,
Nasrin Yazdani
,
Ali Kouhi
Abstract
Background and Aim: Wideband Acoustic Immittance (WAI) is shown to have superior accuracy in diagnosis of middle ear diseases compared to conventional audiometric measurements. Recent studies have focused on investigating its utility in diagnosis of Enlarged Vestibular Aqueduct (EVA). However, the findings have been different across studies. This study pools the existing evidence on WAI findings in patients with EVA.
Recent Findings: A comprehensive search was performed in different databases up to October, 2025. A total of eight studies, including 645 ears, met the inclusion criteria, and seven studies were included in the meta-analysis. Ears with EVA had a significantly lower resonance frequency Mean Difference (MD):-174.7; 95% Confidence Interval (95%CI):-221.3,-128.0; p<0.001), and a variable wideband absorbance curve configuration. Significant but narrow differences were identified in the absorbance values at middle and high frequencies. Absorbance at 8000 Hz under ambient pressure presented the most evident difference in EVA compared to controls (MD:0.13; 95% CI:0.06-0.19; p<0.001). In children, absorbance at 8000 Hz under peak pressure was significantly different between EVA and healthy ears (MD:0.08; 95%CI:0.05-0.12; p<001), but the data on ambient pressure was insufficient in this age group. Despite statistical differences, the clinical significance of these findings warrants further investigations with larger sample size.
Conclusion: WAI provides useful information about EVA-related changes in middle and inner-ear mechanics and presents significant differences between EVA and control, but additional studies are needed before it can be recommended as a screening or diagnostic tool.
1. Vigouroux A, Glemain B, Torres R, Jonard L, Loundon N, Ferrary E, et al. Bilateral Enlarged Vestibular Aqueduct: Auditory, Genetic and Radiological Characterization, and Benefits of Cochlear Implants. Otolaryngol Head Neck Surg. 2025;173(5):1215-27. [DOI:10.1002/ohn.1375]
2. Albert S, Blons H, Jonard L, Feldmann D, Chauvin P, Loundon N, et al. SLC26A4 gene is frequently involved in nonsyndromic hearing impairment with enlarged vestibular aqueduct in Caucasian populations. Eur J Hum Genet. 2006;14(6):773-9. [DOI:10.1038/sj.ejhg.5201611]
3. Elmoursy MM. The incidence of enlarged vestibular aqueduct among hearing-impaired children: hospital-based tertiary care referral center. Egypt J Otolaryngol. 2022;38:145. [DOI:10.1186/s43163-022-00333-8]
4. Pryor SP, Madeo AC, Reynolds JC, Sarlis NJ, Arnos KS, Nance WE, et al. SLC26A4/PDS genotype-phenotype correlation in hearing loss with enlargement of the vestibular aqueduct (EVA): evidence that Pendred syndrome and non-syndromic EVA are distinct clinical and genetic entities. J Med Genet. 2005;42(2):159-65. [DOI:10.1136/jmg.2004.024208]
5. Colvin IB, Beale T, Harrop-Griffiths K. Long-term follow-up of hearing loss in children and young adults with enlarged vestibular aqueducts: relationship to radiologic findings and Pendred syndrome diagnosis. Laryngoscope. 2006;116(11):2027-36. [DOI:10.1097/01.mlg.0000240908.88759.fe]
6. Suzuki H, Oshima A, Tsukamoto K, Abe S, Kumakawa K, Nagai K, et al. Clinical characteristics and genotype-phenotype correlation of hearing loss patients with SLC26A4 mutations. Acta Otolaryngol. 2007;127(12):1292-7. [DOI:10.1080/00016480701258739]
7. Ruthberg JS, Kocharyan A, Farrokhian N, Stahl MC, Hicks K, Scarborough J, et al. Hearing loss patterns in enlarged vestibular aqueduct syndrome: Do fluctuations have clinical significance? Int J Pediatr Otorhinolaryngol. 2022;156:111072. [DOI:10.1016/j.ijporl.2022.111072]
8. Valvassori GE, Clemis JD. The large vestibular aqueduct syndrome. The Laryngoscope. 1978;88(5):723-8. [DOI:10.1002/lary.1978.88.5.723]
9. Juliano AF, Ting EY, Mingkwansook V, Hamberg LM, Curtin HD. Vestibular Aqueduct Measurements in the 45° Oblique (Pöschl) Plane. AJNR Am J Neuroradiol. 2016;37(7):1331-7. [DOI:10.3174/ajnr.A4735]
10. Naganawa S, Ito T, Iwayama E, Fukatsu H, Ishigaki T, Nakashima T, et al. MR imaging of the cochlear modiolus: area measurement in healthy subjects and in patients with a large endolymphatic duct and sac. Radiology. 1999;213(3):819-23. [DOI:10.1148/radiology.213.3.r99dc05819]
11. Boston M, Halsted M, Meinzen-Derr J, Bean J, Vijayasekaran S, Arjmand E, et al. The large vestibular aqueduct: a new definition based on audiologic and computed tomography correlation. Otolaryngol Head Neck Surg. 2007;136(6):972-7. [DOI:10.1016/j.otohns.2006.12.011]
12. Stahl MC, Otteson T. Systematic Review on Vestibular Symptoms in Patients with Enlarged Vestibular Aqueducts. Laryngoscope. 2022;132(4):873-80. [DOI:10.1002/lary.29819]
13. Govaerts P, Casselman J, Daemers K, De Ceulaer G, Somers T, Offeciers F. Audiological findings in large vestibular aqueduct syndrome. International journal of pediatric otorhinolaryngology. 1999;51(3):157-64. [DOI:10.1016/s0165-5876(99)00268-2]
14. Gopen Q, Zhou G, Whittemore K, Kenna M. Enlarged vestibular aqueduct: review of controversial aspects. Laryngoscope. 2011;121(9):1971-8. [DOI:10.1002/lary.22083]
15. Abou-Elew M, El-Khousht M, El-Minawi MS, Selim M, Kamel AI. Enlarged vestibular aqueduct in congenital non-syndromic sensorineural hearing loss in egypt. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):88-94. [DOI:10.1007/s12070-011-0327-2]
16. Archibald HD, Ascha M, Gupta A, Megerian C, Otteson T. Hearing loss in unilateral and bilateral enlarged vestibular aqueduct syndrome. Int J Pediatr Otorhinolaryngol. 2019;118:147-51. [DOI:10.1016/j.ijporl.2018.12.023]
17. Sanford CA, Hunter LL, Feeney MP, Nakajima HH. Wideband acoustic immittance: tympanometric measures. Ear Hear. 2013;34 Suppl 1:65S-71S. [DOI:10.1097/AUD.0b013e31829c7250]
18. Merchant GR, Al-Salim S, Tempero RM, Fitzpatrick D, Neely ST. Improving the Differential Diagnosis of Otitis Media with Effusion Using Wideband Acoustic Immittance. Ear Hear. 2021;42(5):1183-94. [DOI:10.1097/AUD.0000000000001037]
19. Arslan M, Ocak E, Yılmaz ST. Wideband Absorption for Diagnosing Conductive Hearing Loss: Insights from Middle Ear Pathologies. J Acad Res Med. 2024;14(3):131-7. [DOI:10.4274/jarem.galenos.2024.10327]
20. Demir E, Afacan NN, Celiker M, Celiker FB, İnecikli MF, Terzi S, et al. Can Wideband Tympanometry Be Used as a Screening Test for Superior Semicircular Canal Dehiscence? Clin Exp Otorhinolaryngol. 2019;12(3):249-54. [DOI:10.21053/ceo.2018.01137]
21. Murakami S, Gyo K, Goode RL. Effect of increased inner ear pressure on middle ear mechanics. Otolaryngol Head Neck Surg. 1998;118(5):703-8. [DOI:10.1177/019459989811800528]
22. Merchant SN, Rosowski JJ. Conductive hearing loss caused by third-window lesions of the inner ear. Otol Neurotol. 2008;29(3):282-9. [DOI:10.1097/mao.0b013e318161ab24]
23. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89. [DOI:10.1186/s13643-021-01626-4]
24. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2 Group. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529-36. [DOI:10.7326/0003-4819-155-8-201110180-00009]
25. Viechtbauer W. Conducting meta-analyses in R with the metafor package. Journal of statistical software. 2010;36(3):1-48. [DOI:10.18637/jss.v036.i03]
26. Zhang L, Wang J, Zhao F, Li Y. Inner ear pressure evaluation using wideband tympanometry in children with Large Vestibular Aqueduct Syndrome (LVAS): A pilot study. Int J Pediatr Otorhinolaryngol. 2020;128:109690. [DOI:10.1016/j.ijporl.2019.109690]
27. Zhao Z, Ren C, Fan X, Zha D, Lin Y. Study on characteristics of wideband acoustic immittance in patients with Inner Ear Malformations. Int J Pediatr Otorhinolaryngol. 2024;176:111802. [DOI:10.1016/j.ijporl.2023.111802]
28. Li A, Du H, Gao J, Xu Y, Zhao N, Gao S, et al. Characteristics of large vestibular aqueduct syndrome in wideband acoustic immittance. Front Neurosci. 2023;17:1185033. [DOI:10.3389/fnins.2023.1185033]
29. Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, et al. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon. 2024;10(13):e33776. [DOI:10.1016/j.heliyon.2024.e33776]
30. Zhang L, Wang J, Grais EM, Li Y, Zhao F. Three-dimensional wideband absorbance immittance findings in young adults with large vestibular aqueduct syndrome. Laryngoscope Investig Otolaryngol. 2022;8(1):236-44. [DOI:10.1002/lio2.988]
31. Jiang W, Mu Y, Lin H, Shen C, Zhang H, Zhao F, et al. Effects of inner ear abnormalities on middle ear mechanics: Findings from adults with MD and LVAS. Braz J Otorhinolaryngol. 2026;92(1):101673. [DOI:10.1016/j.bjorl.2025.101673]
32. Janky KL, Patterson JN, Kelly EA, Merchant GR. Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance as Screening Tools for Large Vestibular Aqueduct Syndrome. J Am Acad Audiol. 2025;36(3):160-71. [DOI:10.3766/jaaa.240059]
33. Ganaha A, Nojiri N, Nakamura T, Higa T, Kondo S, Tono T. Diagnosis of Enlarged Vestibular Aqueduct Using Wideband Tympanometry. J Clin Med. 2024;13(21):6602. [DOI:10.3390/jcm13216602]
34. Kim J, Koo M. Mass and Stiffness Impact on the Middle Ear and the Cochlear Partition. J Audiol Otol. 2015;19(1):1-6. [DOI:10.7874/jao.2015.19.1.1]
35. Sato E, Nakashima T, Lilly DJ, Fausti SA, Ueda H, Misawa H, et al. Tympanometric findings in patients with enlarged vestibular aqueducts. Laryngoscope. 2002;112(9):1642-6. [DOI:10.1097/00005537-200209000-00021]
36. Velikoselskii A, Papatziamos G, Smeds H, Verrecchia L. Wideband tympanometry in ears with superior canal dehiscence before and after surgical correction. Int J Audiol. 2022;61(8):692-7. [DOI:10.1080/14992027.2021.1964041]
37. Demir E, Celiker M, Aydogan E, Balaban GA, Dursun E. Wideband Tympanometry in Meniere's Disease. Indian J Otolaryngol Head Neck Surg. 2020;72(1):8-13. [DOI:10.1007/s12070-019-01709-8]
38. Sharifi A, Sajjadi H, Ghaedsharaf S, Zarch VV, Ashkboos K, Soroushan A, et al. Exploring the role of wideband tympanometry in diagnosis of Meniere’s disease: a systematic review and meta-analysis. Indian J Otol. 2025;31(4):221-9. [DOI:10.4103/indianjotol.indianjotol_131_24]
39. Miehe J, Mogensen S, Lyhne N, Skals R, Hougaard DD. Wideband tympanometry as a diagnostic tool for Meniere's disease: a retrospective case-control study. Eur Arch Otorhinolaryngol. 2022;279(4):1831-41. [DOI:10.1007/s00405-021-06882-7]
40. Lazarou I, Sideris G, Papadimitriou N, Delides A, Korres G. Third Window Syndrome: An Up-to-Date Systematic Review of Causes, Diagnosis, and Treatment. J Audiol Otol. 2025;29(2):86-94. [DOI:10.7874/jao.2024.00696]
41. Liu X, Ren L, Li J, Ji F, Liu X, Du Y, et al. Air and bone-conducted vestibular evoked myogenic potentials in children with large vestibular aqueduct syndrome. Acta Otolaryngol. 2021;141(1):50-6. [DOI:10.1080/00016489.2020.1815836]
42. Zhu HY, Guo XT, Sun JQ, Sun JW. Characteristics of electrically evoked auditory brainstem response in children with large vestibular aqueduct syndrome after cochlear implantation. Acta Otolaryngol. 2022;142(1):52-6. [DOI:10.1080/00016489.2021.2012255]
43. Dlugaiczyk J, Rösch S, Mantokoudis G. Update on diagnostic procedures in third window syndromes. HNO. 2025;73(Suppl 3):339-47. [DOI:10.1007/s00106-024-01467-2]
44. Sharifi A, Kouhi A, Brodsky JR, Samadizadeh S, Ghaedsharaf S, Farasat E. The Impacts of Cochlear Implantation on Wideband Tympanometry: A Systematic Review. Indian J Otolaryngol Head Neck Surg. 2025;78:545-53. [DOI:10.1007/s12070-025-06197-7]
2. Albert S, Blons H, Jonard L, Feldmann D, Chauvin P, Loundon N, et al. SLC26A4 gene is frequently involved in nonsyndromic hearing impairment with enlarged vestibular aqueduct in Caucasian populations. Eur J Hum Genet. 2006;14(6):773-9. [DOI:10.1038/sj.ejhg.5201611]
3. Elmoursy MM. The incidence of enlarged vestibular aqueduct among hearing-impaired children: hospital-based tertiary care referral center. Egypt J Otolaryngol. 2022;38:145. [DOI:10.1186/s43163-022-00333-8]
4. Pryor SP, Madeo AC, Reynolds JC, Sarlis NJ, Arnos KS, Nance WE, et al. SLC26A4/PDS genotype-phenotype correlation in hearing loss with enlargement of the vestibular aqueduct (EVA): evidence that Pendred syndrome and non-syndromic EVA are distinct clinical and genetic entities. J Med Genet. 2005;42(2):159-65. [DOI:10.1136/jmg.2004.024208]
5. Colvin IB, Beale T, Harrop-Griffiths K. Long-term follow-up of hearing loss in children and young adults with enlarged vestibular aqueducts: relationship to radiologic findings and Pendred syndrome diagnosis. Laryngoscope. 2006;116(11):2027-36. [DOI:10.1097/01.mlg.0000240908.88759.fe]
6. Suzuki H, Oshima A, Tsukamoto K, Abe S, Kumakawa K, Nagai K, et al. Clinical characteristics and genotype-phenotype correlation of hearing loss patients with SLC26A4 mutations. Acta Otolaryngol. 2007;127(12):1292-7. [DOI:10.1080/00016480701258739]
7. Ruthberg JS, Kocharyan A, Farrokhian N, Stahl MC, Hicks K, Scarborough J, et al. Hearing loss patterns in enlarged vestibular aqueduct syndrome: Do fluctuations have clinical significance? Int J Pediatr Otorhinolaryngol. 2022;156:111072. [DOI:10.1016/j.ijporl.2022.111072]
8. Valvassori GE, Clemis JD. The large vestibular aqueduct syndrome. The Laryngoscope. 1978;88(5):723-8. [DOI:10.1002/lary.1978.88.5.723]
9. Juliano AF, Ting EY, Mingkwansook V, Hamberg LM, Curtin HD. Vestibular Aqueduct Measurements in the 45° Oblique (Pöschl) Plane. AJNR Am J Neuroradiol. 2016;37(7):1331-7. [DOI:10.3174/ajnr.A4735]
10. Naganawa S, Ito T, Iwayama E, Fukatsu H, Ishigaki T, Nakashima T, et al. MR imaging of the cochlear modiolus: area measurement in healthy subjects and in patients with a large endolymphatic duct and sac. Radiology. 1999;213(3):819-23. [DOI:10.1148/radiology.213.3.r99dc05819]
11. Boston M, Halsted M, Meinzen-Derr J, Bean J, Vijayasekaran S, Arjmand E, et al. The large vestibular aqueduct: a new definition based on audiologic and computed tomography correlation. Otolaryngol Head Neck Surg. 2007;136(6):972-7. [DOI:10.1016/j.otohns.2006.12.011]
12. Stahl MC, Otteson T. Systematic Review on Vestibular Symptoms in Patients with Enlarged Vestibular Aqueducts. Laryngoscope. 2022;132(4):873-80. [DOI:10.1002/lary.29819]
13. Govaerts P, Casselman J, Daemers K, De Ceulaer G, Somers T, Offeciers F. Audiological findings in large vestibular aqueduct syndrome. International journal of pediatric otorhinolaryngology. 1999;51(3):157-64. [DOI:10.1016/s0165-5876(99)00268-2]
14. Gopen Q, Zhou G, Whittemore K, Kenna M. Enlarged vestibular aqueduct: review of controversial aspects. Laryngoscope. 2011;121(9):1971-8. [DOI:10.1002/lary.22083]
15. Abou-Elew M, El-Khousht M, El-Minawi MS, Selim M, Kamel AI. Enlarged vestibular aqueduct in congenital non-syndromic sensorineural hearing loss in egypt. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):88-94. [DOI:10.1007/s12070-011-0327-2]
16. Archibald HD, Ascha M, Gupta A, Megerian C, Otteson T. Hearing loss in unilateral and bilateral enlarged vestibular aqueduct syndrome. Int J Pediatr Otorhinolaryngol. 2019;118:147-51. [DOI:10.1016/j.ijporl.2018.12.023]
17. Sanford CA, Hunter LL, Feeney MP, Nakajima HH. Wideband acoustic immittance: tympanometric measures. Ear Hear. 2013;34 Suppl 1:65S-71S. [DOI:10.1097/AUD.0b013e31829c7250]
18. Merchant GR, Al-Salim S, Tempero RM, Fitzpatrick D, Neely ST. Improving the Differential Diagnosis of Otitis Media with Effusion Using Wideband Acoustic Immittance. Ear Hear. 2021;42(5):1183-94. [DOI:10.1097/AUD.0000000000001037]
19. Arslan M, Ocak E, Yılmaz ST. Wideband Absorption for Diagnosing Conductive Hearing Loss: Insights from Middle Ear Pathologies. J Acad Res Med. 2024;14(3):131-7. [DOI:10.4274/jarem.galenos.2024.10327]
20. Demir E, Afacan NN, Celiker M, Celiker FB, İnecikli MF, Terzi S, et al. Can Wideband Tympanometry Be Used as a Screening Test for Superior Semicircular Canal Dehiscence? Clin Exp Otorhinolaryngol. 2019;12(3):249-54. [DOI:10.21053/ceo.2018.01137]
21. Murakami S, Gyo K, Goode RL. Effect of increased inner ear pressure on middle ear mechanics. Otolaryngol Head Neck Surg. 1998;118(5):703-8. [DOI:10.1177/019459989811800528]
22. Merchant SN, Rosowski JJ. Conductive hearing loss caused by third-window lesions of the inner ear. Otol Neurotol. 2008;29(3):282-9. [DOI:10.1097/mao.0b013e318161ab24]
23. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89. [DOI:10.1186/s13643-021-01626-4]
24. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2 Group. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529-36. [DOI:10.7326/0003-4819-155-8-201110180-00009]
25. Viechtbauer W. Conducting meta-analyses in R with the metafor package. Journal of statistical software. 2010;36(3):1-48. [DOI:10.18637/jss.v036.i03]
26. Zhang L, Wang J, Zhao F, Li Y. Inner ear pressure evaluation using wideband tympanometry in children with Large Vestibular Aqueduct Syndrome (LVAS): A pilot study. Int J Pediatr Otorhinolaryngol. 2020;128:109690. [DOI:10.1016/j.ijporl.2019.109690]
27. Zhao Z, Ren C, Fan X, Zha D, Lin Y. Study on characteristics of wideband acoustic immittance in patients with Inner Ear Malformations. Int J Pediatr Otorhinolaryngol. 2024;176:111802. [DOI:10.1016/j.ijporl.2023.111802]
28. Li A, Du H, Gao J, Xu Y, Zhao N, Gao S, et al. Characteristics of large vestibular aqueduct syndrome in wideband acoustic immittance. Front Neurosci. 2023;17:1185033. [DOI:10.3389/fnins.2023.1185033]
29. Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, et al. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon. 2024;10(13):e33776. [DOI:10.1016/j.heliyon.2024.e33776]
30. Zhang L, Wang J, Grais EM, Li Y, Zhao F. Three-dimensional wideband absorbance immittance findings in young adults with large vestibular aqueduct syndrome. Laryngoscope Investig Otolaryngol. 2022;8(1):236-44. [DOI:10.1002/lio2.988]
31. Jiang W, Mu Y, Lin H, Shen C, Zhang H, Zhao F, et al. Effects of inner ear abnormalities on middle ear mechanics: Findings from adults with MD and LVAS. Braz J Otorhinolaryngol. 2026;92(1):101673. [DOI:10.1016/j.bjorl.2025.101673]
32. Janky KL, Patterson JN, Kelly EA, Merchant GR. Vestibular Evoked Myogenic Potentials and Wideband Acoustic Immittance as Screening Tools for Large Vestibular Aqueduct Syndrome. J Am Acad Audiol. 2025;36(3):160-71. [DOI:10.3766/jaaa.240059]
33. Ganaha A, Nojiri N, Nakamura T, Higa T, Kondo S, Tono T. Diagnosis of Enlarged Vestibular Aqueduct Using Wideband Tympanometry. J Clin Med. 2024;13(21):6602. [DOI:10.3390/jcm13216602]
34. Kim J, Koo M. Mass and Stiffness Impact on the Middle Ear and the Cochlear Partition. J Audiol Otol. 2015;19(1):1-6. [DOI:10.7874/jao.2015.19.1.1]
35. Sato E, Nakashima T, Lilly DJ, Fausti SA, Ueda H, Misawa H, et al. Tympanometric findings in patients with enlarged vestibular aqueducts. Laryngoscope. 2002;112(9):1642-6. [DOI:10.1097/00005537-200209000-00021]
36. Velikoselskii A, Papatziamos G, Smeds H, Verrecchia L. Wideband tympanometry in ears with superior canal dehiscence before and after surgical correction. Int J Audiol. 2022;61(8):692-7. [DOI:10.1080/14992027.2021.1964041]
37. Demir E, Celiker M, Aydogan E, Balaban GA, Dursun E. Wideband Tympanometry in Meniere's Disease. Indian J Otolaryngol Head Neck Surg. 2020;72(1):8-13. [DOI:10.1007/s12070-019-01709-8]
38. Sharifi A, Sajjadi H, Ghaedsharaf S, Zarch VV, Ashkboos K, Soroushan A, et al. Exploring the role of wideband tympanometry in diagnosis of Meniere’s disease: a systematic review and meta-analysis. Indian J Otol. 2025;31(4):221-9. [DOI:10.4103/indianjotol.indianjotol_131_24]
39. Miehe J, Mogensen S, Lyhne N, Skals R, Hougaard DD. Wideband tympanometry as a diagnostic tool for Meniere's disease: a retrospective case-control study. Eur Arch Otorhinolaryngol. 2022;279(4):1831-41. [DOI:10.1007/s00405-021-06882-7]
40. Lazarou I, Sideris G, Papadimitriou N, Delides A, Korres G. Third Window Syndrome: An Up-to-Date Systematic Review of Causes, Diagnosis, and Treatment. J Audiol Otol. 2025;29(2):86-94. [DOI:10.7874/jao.2024.00696]
41. Liu X, Ren L, Li J, Ji F, Liu X, Du Y, et al. Air and bone-conducted vestibular evoked myogenic potentials in children with large vestibular aqueduct syndrome. Acta Otolaryngol. 2021;141(1):50-6. [DOI:10.1080/00016489.2020.1815836]
42. Zhu HY, Guo XT, Sun JQ, Sun JW. Characteristics of electrically evoked auditory brainstem response in children with large vestibular aqueduct syndrome after cochlear implantation. Acta Otolaryngol. 2022;142(1):52-6. [DOI:10.1080/00016489.2021.2012255]
43. Dlugaiczyk J, Rösch S, Mantokoudis G. Update on diagnostic procedures in third window syndromes. HNO. 2025;73(Suppl 3):339-47. [DOI:10.1007/s00106-024-01467-2]
44. Sharifi A, Kouhi A, Brodsky JR, Samadizadeh S, Ghaedsharaf S, Farasat E. The Impacts of Cochlear Implantation on Wideband Tympanometry: A Systematic Review. Indian J Otolaryngol Head Neck Surg. 2025;78:545-53. [DOI:10.1007/s12070-025-06197-7]
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How to Cite
1.
Sharifi A, Zamani R, Brodsky J, Yaghoubi Hamgini M, Samadizadeh S, Yazdani N, Kouhi A. Wideband Acoustic Immittance Patterns in Enlarged Vestibular Aqueduct: A Systematic Review and Meta-Analysis. Aud Vestib Res. 2026;.
