The cochlear aqueduct and its significance in hearing pathology. Literature review and clinical case

The article presents a literature review on the human cochlear aqueduct. It describes the anatomy of the cochlear aqueduct that became available using high-resolution computed tomography of the temporal bones, methods for assessing the size of the cochlear aqueduct, types of cochlear aqueducts, and reasons for the occasional lack of visualization of the cochlear aqueduct on computed tomograms. The criteria and validity of the concepts of “wide” and “narrow” cochlear aqueduct, the patency of the cochlear aqueduct and its changes with age, the role of the cochlear aqueduct in the development of purulent inflammation in the structures of the labyrinth of the inner ear, perilymphatic hypertension, and temporary perilymphatic hypotension are analyzed. The literature data show that the existence of an anatomically and functionally wide, or more precisely, excessively patent, cochlear aqueduct is possible. Pathological conditions of the cochlear aqueduct and its interaction with adjacent anatomical structures are discussed. A clinical case of unilateral fluctuating hearing loss is presented, in which a congenital anomaly of the inner ear development was detected on a CT scan – dehiscence between the abnormally large bulb of the jugular vein and the cochlear aqueduct. To assess the contribution of the aqueduct to the pathology of the inner ear, more attention to this anatomical structure and further accumulation of data are required.