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What is EVA? Enlarged Vestibular Aqueduct (EVA) is syndrome that has progressive hearing loss associated with it. EVA is diagnosed when an MRI or CT Scan reveals enlarged vestibular aqueducts. Vestibular aqueducts are bony canals that travel from the inner ear to the temporal bone. Running through the vestibular aqueduct is a fluid-filled tube called the endolympatic duct, which connects the inner ear to the endolymphatic sac. When the aqueduct is enlarged, the endolymphatic sac and duct enlarge and fill the space. Scientists believe that the endolymphatic duct and sac help regulate the concentration of ions in cochlear fluids and this enlargement may result in a chemical imbalance. Scientists are finding that 5-15% of children with sensorineural hearing loss have EVA. Any minor head trauma, change in barometric pressure or physical exertion can cause an irreversible drop in hearing. Surgery cannot correct this condition. If you have a student on your caseload with EVA, it is advised they be excluded from participating in contact sports in PE class. These students should be tested at least twice a year to monitor their hearing loss and receive hearing aid adjustments if necessary. This is especially important in infants and toddlers who cannot convey that a change in their hearing has occurred.