Clinical Predictors of Abnormal Magnetic Resonance Imaging Findings in Patients With Asymmetric Sensorineural Hearing Loss

Ahsan, Syed F.; Standring, Robert T.; Osborn, D. A.; Peterson, Edward L.; Seidman, Michael D.; Jain, Rajan

doi:10.1001/jamaoto.2015.142

Cited by 31 publications

(25 citation statements)

References 23 publications

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“…Among them, 91 patients with a history of dizziness were excluded. ASNHL was defined as a ≥ 15 dB difference at one or more frequencies with no conductive component or ≥ 15% difference in speech discrimination scores (SDS) between ears [17,18]. Of the 348 patients, 157 met the ASNHL criteria and were finally included in our study.…”

Section: Methodsmentioning

confidence: 99%

Silent Vestibulopathy in Asymmetric Hearing Loss Can Be a Sign of a Cerebellopontine Angle Tumor

Sunwoo

Jeon

Park

et al. 2018

JOHBM

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Abstract:The presence of an ipsilateral cerebellopontine angle (CPA) tumor should be ruled out in patients with asymmetric sensorineural hearing loss (ASNHL). Although many patients with CPA tumors have ipsilateral vestibular hypofunction, some of them do not experience dizziness even with ipsilateral vestibular hypofunction. We analyzed the incidence of CPA tumors among patients with ASNHL without subjective dizziness based on the presence of vestibulopathy. We hypothesized that a patient with silent unilateral vestibular hypofunction (UVH) is more likely to be diagnosed with a CPA tumor. Among 157 subjects who underwent MRI for ASNHL, those who did not have "subjective dizziness" were selected. All subjects underwent hearing and vestibular function tests. UVH was diagnosed if canal paresis ≥ 25%, positive head-shake nystagmus, or gain of head-impulse test < 0.8 were detected. The diameters of the CPA tumors were measured along the petrosal ridge on the axial plane of MRI. Among the enrolled subjects, 44 (28.02%) were diagnosed with a CPA tumor. The 37 patients (84.1%) with a CPA tumor had silent UVH, while only 33 of the 113 patients (29.2%) without a CPA tumor had silent UVH (chi-square test, odds ratio = 12.8, p < 0.001). Silent UVH in patients with ASNHL may be a sign of a CPA tumor.

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Section: Methodsmentioning

confidence: 99%

Silent Vestibulopathy in Asymmetric Hearing Loss Can Be a Sign of a Cerebellopontine Angle Tumor

Sunwoo

Jeon

Park

et al. 2018

JOHBM

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“…A significant difficulty with establishing the sensitivity and specificity of MRI for VS is that the prevalence of VS is fairly consistent across adult populations (about 1/100,000), but the prevalence of ASNHL is much more common and highly variable across different populations. This point was illustrated by Pena et al, who studied audiometry and VS in a cohort of 76 US military veterans with VS and 152 pair‐matched controls from the same population.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Saliba estimated that their method would detect VS in about 2% of MRI scans. 5 Ahsan et al 2 retrospectively evaluated 451 cases who had MRI to evaluate ASNHL. They reviewed the audiometric and clinical findings from clinical charts.…”

Section: Literature Reviewmentioning

confidence: 99%

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Which Patients With Asymmetric Sensorineural Hearing Loss Should Undergo Imaging?

Gupta

Monsell

2018

The Laryngoscope

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“…Многими исследователями обсуждается вопрос о диагностической значимости АСНТ при раннем выявлении акустической невриномы. По некоторым данным [14,15], большее внимание необходимо уделять асимметрии по порогам на частоте 3 кГц, превышающей 15 дБ. По другим сведениям, значимой считается асимметрия не менее 20 дБ на двух соседних частотах (или 15 дБ на двух соседних частотах в диапазоне от 2 до 8 кГц) [16].…”

Section: результаты и обсуждениеunclassified

Asymmetric sensorineural hearing impairment in the adult population

Tufatulin

Boboshko²,

Artyushkin

2018

Vestn. otorinolaringol.

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The relevance of the problem of a sensorineural hearing loss (ASNL) arises from the necessity of the special approaches to the diagnostics of this condition, the complications accompanying this pathology, and the difficulties encountered in the implementation of the methods designed for hearing rehabilitation of such patients. The objective of the present study was to estimate the prevalence of ASHL among the adult population. The sensorineural impairment of hearing was diagnosed in a total of 2456 (72%) examined patients presenting with hearing loss. To determine the presence of asymmetry of sensorineural hearing loss, we employed three counting techniques allowing (1) to calculate the difference between the average hearing thresholds at four frequencies within the range from 0.5 to 4 kHz (the difference was found to be 15 dB or more in 17% of the patients), (2) to calculate the difference between the degrees of hearing loss in the right and left ears (the difference was documented in 47% of the patients), (3) to calculate the difference between the hearing thresholds at least at a single frequency within the range from 0.125 to 8 kHz (he difference was found to be 15 dB or more in 71% of the patients). When using the third method to characterize asymmetry of hearing impairment, it was identified in most patients (53%) at one or two frequencies. Moreover, there was a large number of the patients (13%) with asymmetry apparent over the entire frequency range. A high degree of threshold asymmetry (in excess of 40 dB) was more often noted in the mid-frequency range. In the majority of the patients, the asymmetry manifested itself as the different degree of bilateral sensorineural hearing impairment (51%) or unilateral sensorineural hearing loss with the normal hearing ability preserved in the contralateral ear (35%). The results of the present study give evidence of the necessity of developing a reliable method for the identification of clinically significant ACNL.

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Clinical Predictors of Abnormal Magnetic Resonance Imaging Findings in Patients With Asymmetric Sensorineural Hearing Loss

Abstract: This study found that asymmetry of 15 dB at 3 kHz on audiometry was associated with higher positive yield on use of MRI in evaluating patients with ASNHL. We recommend that patients who present with ASNHL with this audiometric characteristic undergo MRI as part of their diagnostic workup.

Cited by 31 publications

References 23 publications

Silent Vestibulopathy in Asymmetric Hearing Loss Can Be a Sign of a Cerebellopontine Angle Tumor

Silent Vestibulopathy in Asymmetric Hearing Loss Can Be a Sign of a Cerebellopontine Angle Tumor

Which Patients With Asymmetric Sensorineural Hearing Loss Should Undergo Imaging?

Asymmetric sensorineural hearing impairment in the adult population

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