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Although large vestibular aqueducts are a congenital condition, hearing loss may not be present from birth. Age of diagnosis ranges from infancy to adulthood, and symptoms include fluctuating and sometimes progressive sensorineural hearing loss and disequilibrium. It is possible that a small portion of those with large vestibular aqueducts will not exhibit auditory symptoms such as hearing loss. While this is uncommon, hearing loss can progress later in life especially after head trauma. Hearing loss can be unilateral or bilateral and can be sensorineural, conductive, or mixed. Vestibular symptoms, such as vertigo and imbalance, occur in adult patients 45% of the time.