Diagnostic value and prognostic significance of MRI findings in sudden sensorineural hearing loss.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_C720652EC48A
Type
Article: article from journal or magazin.
Collection
Publications
Title
Diagnostic value and prognostic significance of MRI findings in sudden sensorineural hearing loss.
Journal
Laryngoscope investigative otolaryngology
Author(s)
Todic J., Guinand N., Lenoir V., Senn P., Becker M.
ISSN
2378-8038 (Print)
ISSN-L
2378-8038
Publication state
Published
Issued date
10/2022
Peer-reviewed
Oui
Volume
7
Number
5
Pages
1575-1583
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
We evaluated the clinical significance of magnetic resonance imaging (MRI) findings and their prognostic value for initial hearing loss and recovery in patients with sudden sensorineural hearing loss (SSNHL).
This retrospective study included consecutive adult patients with unilateral SSNHL, contrast-enhanced MRI and audiometric testing evaluated in our institution between 2005 and 2017. MRI reports, patient data, treatment, and audiometric tests were reviewed, with the relationship between MRI findings and hearing loss/recovery analyzed.
Overall, 266 patients were included. Additional symptoms comprised tinnitus (114/266; 43%), vertigo (45/266; 17%), ear pain (26/266; 10%), and ear pressure (6/266; 2%). At least one cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, cardiopathy, and active smoking) existed in 167/266 (63%) patients. Corticosteroid treatment was followed by 198/266 (74%) patients while contraindications/refusal/compliance precluded treatment in 68/266(26%). Complete, partial or slight hearing recovery occurred in 167/266 (63%) patients. Three MRI patient groups were identified: a group with normal MRI examinations or incidentalomas (128/266; 48%), a group with peripheral auditory system (PAS) lesions (95/266; 36%), and a group with central nervous system (CNS) lesions (43/266; 16%). PAS lesions included lesions from the cochlea to the brain stem (e.g., schwannoma, meningioma, labyrinthitis, intracochlear hemorrhage, vestibulocochlear neuritis), whereas CNS lesions corresponded in 42/43(98%) of cases to leukoaraiosis and other vascular lesions (e.g., stroke, hemorrhage, aneurysm, venous sinus thrombosis, and cavernoma). Belonging to one of the three MRI groups did not influence the degree of initial hearing loss, affected frequencies or treatment, p > .05. Gender and cardiovascular risk factors did neither affect initial hearing loss nor recovery. However, age > 70 years negatively affected initial hearing loss in all frequencies, as well as recovery in all frequencies except 1000 Hz. Also, poor recovery of initial high-frequency hearing loss (>1000 Hz) was significantly associated with CNS lesions.
Age > 70 years and CNS lesions depicted by MRI independently predicted poor auditory recovery, albeit in different frequencies.
In patients with sudden hearing loss, older age (above 70 years) predicts poorer hearing recovery than in younger patients in most hearing frequencies. In addition, abnormalities of brain tissue revealed by MRI predict poorer hearing recovery at high frequencies.
Level III.
Keywords
hearing loss, hearing recovery, magnetic resonance imaging (MRI), prognosis, sudden sensorineural hearing loss (SSNHL)
Pubmed
Web of science
Open Access
Yes
Create date
24/10/2022 12:16
Last modification date
24/01/2024 11:49
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