• Dr A A Mundewadi

Ayurvedic Herbal Treatment for Enlarged Vestibular Aqueduct Syndrome (EVAS)

The vestibular aqueduct is a tiny bony canal which extends from the inner ear endolymphatic space towards the brain. Enlarged vestibular aqueduct can cause symptoms associated with hearing and balance, and this is known as enlarged vestibular aqueduct syndrome (EVAS). Genetic and environmental factors are responsible for this condition. About 70 to 80% of this condition causes only hearing loss and is therefore non-syndromic. The Pendred syndrome causes hearing loss as well as thyroid dysfunction and is seen in one-third cases of EVAS. Sometimes the neck as well as the kidneys can also be affected in addition to hearing dysfunction. Usually, hearing is normal in the first few years of life. Hearing loss becomes noticeable in early childhood, usually after incidents like head trauma, upper respiratory tract infection, jumping, and air travel. Usually there is a gradually progressive hearing loss, tinnitus as well as vertigo. Children experience balance and coordination problems. Hearing loss is usually sensorineural in origin, but may rarely also be due to conductive hearing impairment. The long-term course of this condition is variable, and varies from few symptoms to profound hearing loss as well as severe associated symptoms.

Ayurvedic herbal treatment for EVAS is related to providing symptomatic improvement according to the presentation of symptoms in each individual. Herbal medicines are given to possibly reduce the size of the bony canal which is responsible for symptoms. Other herbal medicines are used to reduce the pressure of the excess fluid which is responsible for causing hearing loss and other symptoms. Long-term Ayurvedic treatment is also given so as to protect the outer and inner sensory hair from getting damaged due to EVAS.

Associated symptoms in the syndromic condition need to be treated accordingly. The main aim of treatment with Ayurvedic herbal medicines is to bring about in improvement in the hearing loss as well as prevent long-term permanent damage related to the ears as well as to the other organs in the body. Herbal treatment is safe for long-term use and can therefore be safely used both in children as well as affected adults. Treatment with Ayurvedic herbal medicines needs to be started as early as possible, in order to obtain the maximum possible benefit from treatment. Ayurvedic treatment initially needs to be given for periods ranging from four to six months. Ayurvedic herbal treatment thus has a significant role to play in the management and treatment of EVAS.

Enlarged Vestibular Aqueduct Syndrome, EVAS, Ayurvedic treatment, herbal medicines, Pendred Syndrome

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