Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 08 25 1555 1555 Alireza Sharifi Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Raha Zamani Students' Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Jacob Brodsky Department of Otolaryngology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA. Maryam Yaghoubi Hamgini ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Samad Samadizadeh Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran. Nasrin Yazdani Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Kouhi 2026 04 08 2026 08 01 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. https://avr.tums.ac.ir/index.php/avr/article/view/1555 https://avr.tums.ac.ir/index.php/avr/article/download/1555/702