Clinical Features and Prognosis of Sudden Sensorineural Hearing Loss Secondary to Intralabyrinthine Hemorrhage

Lee, Jae Woo; Park, Yoon Ah; Park, Sang Man; Kong, Tae Hoon; Park, Sang Yoo; Bong, Jeong Pyo; Park, Dong-Joon; Seo, Young Joon

doi:10.7874/jao.2016.20.1.31

Cited by 29 publications

(25 citation statements)

References 15 publications

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“…Several previous studies have noted high signal intensity in the inner ear on precontrast and postcontrast 3D-FLAIR MRI and attributed this finding to the breakdown of the blood-labyrinth barrier and the destruction of erythrocytes in the inner ear, which produce intracellular methemoglobin. [10][11][12]15 Therefore, 3D-FLAIR imaging is of great clinical importance for the diagnosis of inner ear hemorrhage and is also an objective technique for evaluating inner ear pathology early in the course of disease. In our study, only 1 patient had abnormal CBC findings, and 2 patients had mildly abnormal coagulation profiles.…”

Section: Discussionmentioning

confidence: 99%

“…Although the incidence of inner ear hemorrhage is low (1.9%), inner ear 3D-FLAIR sequence imaging is vital to diagnose SSNHL accompanied by inner ear hemorrhage and can assist in timely treatment adjustments and provide new radiographic indicators to aid in prognosis. 11,21 Kaya et al 16 found that labyrinthine hemorrhage does not damage inner hair cells, spiral ganglion cells, the stria vascularis, or the spiral ligament. Thus, we speculate that patients with labyrinthine hemorrhage can serve as candidates for amplification with hearing aids or cochlear implants.…”

Section: Discussionmentioning

confidence: 99%

“…As previously reported, high signals in the labyrinth, which can be clearly detected through the 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence, have been documented to support labyrinthine hemorrhage, with a varied incidence of 0.397% to 6.25%. 5,[10][11][12] With its unique advantages, 3D-FLAIR MRI has been applied to investigate the etiology of SSNHL and differentiate pathological conditions in the inner ear. The current study attempted to analyze the different sites of labyrinthine hemorrhage through the application of a 3D-FLAIR sequence and to distinguish hearing impairment patterns and evaluate the prognosis of labyrinthine hemorrhage patients in terms of hearing recovery.…”

Section: Introductionmentioning

confidence: 99%

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The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss

et al. 2019

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To investigate the application of inner ear 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL) accompanied by inner ear hemorrhage. A total of 1252 SSNHL patients who were admitted from January 2010 to April 2018 were included in the study. The patients' clinical features, complete blood counts, coagulation profiles, audiometry data, and MRI scans were retrospectively reviewed. Twenty-four patients had high labyrinth signals on inner ear 3D-FLAIR MRI (24/1252, 1.9%) that were diagnosed as inner ear hemorrhage. One patient had endolymphatic hydrops on the contralesional side. In the 24 patients, pure tone audiometry curves revealed profound deafness (19/24) and flat moderate hearing loss (5/24); most patients had associated vertigo (23/24) and tinnitus (19/24). Patients with SSNHL (N ¼ 24) were treated. Sixteen patients had invalid improvement, 3 patients were markedly improved, 4 patients had effective treatment, and only 1 patient was cured, for a therapeutic efficacy of 33.3% (8/24). Follow-up 3D-FLAIR MRI in patients showed absorbance of labyrinthine hemorrhage and disappearance of the high signal intensity in the inner ear within 2 weeks to 4 months. Inner ear 3D-FLAIR MRI indicate that most cases of inner ear hemorrhage are spontaneous and that high labyrinth signals are absorbed within 4 months. The site of labyrinth hemorrhage is irregular and independent of hearing loss. Conventional treatment is not very effective, and an appropriate therapy for SSNHL requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss

et al. 2019

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“…ILH may cause sudden hearing deterioration with vertigo in a patient on anticoagulant therapy or with a hematological disease; the prevalence has been reported as 0.3–6.25% in patients with SSNHL [ 7 , 22 , 23 ]. In our series of 200 3-T MRI scans, seven (3.6%) patients showed ILH on MRI, which was the second-most common finding after tumors invading the IAC (10 patients, 5.2%).…”

Section: Discussionmentioning

confidence: 99%

Sudden sensorineural hearing loss associated with inner ear lesions detected by magnetic resonance imaging

et al. 2017

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Although recent advances in magnetic resonance imaging (MRI) techniques have contributed to the detection of tiny lesions in the internal auditory canal (IAC) that may be responsible for sudden sensorineural hearing loss (SSNHL), there have been relatively few studies on the clinical characteristics of intra-labyrinthine hemorrhage (ILH) and labyrinthitis versus those regarding IAC tumors. Our purpose was to investigate the frequency of those IAC lesions on MRI and their clinical characteristics. Initial MRIs of 200 patients with SSNHL (93 men, 107 women; mean age = 48.61 years, range: 18–84 years), as well as detailed clinical histories, audiological examinations, and thyroid function, lipid battery, and serological tests (for viral agents and autoimmune disease), were performed. All patients were hospitalized at the time of diagnosis of SSNHL and were administered the same treatment protocol. Patients were divided into idiopathic and secondary groups according to their MRI results. After discharge, they underwent follow-up audiometry and clinical examination at predetermined intervals (2 weeks, 1, 2, 4, and 6 months, and 1 and 2 years). Propensity score-matching and receiver operating characteristics curves of the initial parameters were used for estimating clinical characteristics. Of the 200 patients, 25 (12.55%) who had abnormal findings suggesting inner ear lesions on MRI were assigned to the secondary SSNHL group; within this group, 10 patients (10/200, 5%) had a tumor invading the IAC, 7 (7/200, 3.5%) had ILH, 6 (6/200, 3%) had labyrinthitis, and 2 (1%) had a structural deformity of the IAC. The secondary group showed significantly poor recovery of hearing function compared with that in the idiopathic group. Patients with ILH or labyrinthitis showed prognoses that were equally poor as those of patients with tumors in the secondary group. Additionally, patients with such lesions showed significant canal paresis on the lesion side at an early stage and a high prevalence of benign paroxysmal positional vertigo (BPPV). In conclusion, the prevalence of non-tumorous lesions on MRI represents common findings and showed a poorer treatment response than that of vestibular Schwannoma in patients with SSNHL. Abnormal canal paresis (cut-off value of 35% on the lesioned side, sensitivity 65.2% and specificity 67%), spontaneous nystagmus directed to the contralesional side, and positional vertigo would be the clinical presentation of SSNHL with IAC lesions, in which the presence of acute prolonged vertigo or positional vertigo compatible with BPPV suggests the possibility of a non-tumorous lesion, such as ILH or a labyrinthitis rather than an IAC tumor.

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“…The etiology of ISSNHL is unknown however multifactorial causes including vascular compromise, immunologic diseases, disruption of cochlear membrane, viral infection, trauma, otological tumors, toxicity, neurologic, and metabolic causes are suggested [78]. Although ISSNHL is mainly idiopathic, potential causes should be considered.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Combined Therapeutic Effects of Lipoprostaglandin E1 on Sudden Idiopathic Sensorineural Hearing Loss

Shim

Kim

2017

J Audiol Otol

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Background and ObjectivesViral and vascular disorders are considered to be a major cause of idiopathic sudden sensorineural hearing loss (ISSNHL). Lipoprostaglandin E1 (lipo-PGE1) has vasodilating activity and has been used to treat ISSNHL. The purpose of this study was to determine the specific therapeutic effects of lipo-PGE1 and compare them to other treatment modalities for ISSNHL.Subjects and MethodsThe study group had 1,052 patients diagnosed with ISSNHL. All were treated with steroid, carbogen inhalation, stellate ganglion block (SGB), or PGE1. The CP group (steroid, carbogen inhalation, and PGE1 injection; 288 patients) was treated with lipo-PGE1 and carbogen inhalation, the CS group (steroid, carbogen inhalation, and stellate ganglion block; 232 patients) with steroid, carbogen inhalation, and SGB, the C group (steroid and carbogen inhalation; 284 patients) with steroid and carbogen, and the control group (steroid only; 248 patients) with steroid only. Patients in the groups receiving lipo-PGE1 received a continuous infusion of 10 µL lipo-PGE1.ResultsThe overall recovery rate after treatment was 52.2%, and recovery rates by group were 67.7% in the CP group, 54.3% in the CS group, 52.1% in the C group, and 32.2% in the control group. Therefore, the therapeutic results in groups treated with lipo-PGE1 were better than results in other groups. The difference was statistically significant.ConclusionsThe study results suggested that the CP group received effective treatment modalities for ISSNHL. The combined therapy of lipo-PGE1 with carbogen inhalation in patients with ISSNHL was more beneficial than other treatment modalities.

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Clinical Features and Prognosis of Sudden Sensorineural Hearing Loss Secondary to Intralabyrinthine Hemorrhage

Cited by 29 publications

References 15 publications

The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss

The Natural History of Labyrinthine Hemorrhage in Patients With Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss associated with inner ear lesions detected by magnetic resonance imaging

Comparative Analysis of the Combined Therapeutic Effects of Lipoprostaglandin E1 on Sudden Idiopathic Sensorineural Hearing Loss

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