Clinical Value of 3D-FLAIR MRI in Idiopathic Sudden Sensorineural Hearing Loss

Wang, Mingming; Hu, Na; Wang, Yingjun; Sun, Xiao; Fan, Zhaomin; Wang, Haibo

doi:10.1021/acschemneuro.1c00687

Cited by 6 publications

(11 citation statements)

References 25 publications

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“…Considering the correlation between 3D-FLAIR performance and the prognosis of SSNHL, previous studies had shown some disagreements due to the inconsistencies in examination, diagnosis, and treatment [Berrettini et al, 2013;Lee et al, 2016;Conte et al, 2022;Wang et al, 2022]. In our study, the patients with positive MR findings had a higher incidence of abnormal OAEs and suffered from severe to profound HL.…”

Section: Discussionmentioning

confidence: 49%

Clinical Value of a Novel Magnetic Resonance Imaging Protocol and Prognostic Model Establishment for Sudden Sensorineural Hearing Loss: A Prospective Study

Wang

et al. 2022

Audiol Neurotol

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Introduction: Sudden sensorineural hearing loss (SSNHL) is one of the most common acute symptoms in the otolaryngology department. Etiological diagnosis is the premise of effective treatment of SSNHL, and prognostic evaluation is the key. However, most of the patients are diagnosed as idiopathic due to a lack of overall assessment, while prognostic factors of SSNHL are numerous and controversial. Our purpose was to validate the potential value of a novel three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MR protocol in SSNHL and to establish a clinical-image prognostic model for unilateral SSNHL. Methods: This prospective study included consecutive patients from May 2019 to November 2021. Pathogenic diagnosis relied on expertise-based estimation and the associations of MR findings with clinical features of unilateral SSNHL were assessed. The prognostic evaluation of unilateral SSNHL was adopted for recovery and no recovery groups and complete and incomplete recovery groups. Significant clinical and MR features were compared and screened out by single-factor analyses. The primary clinical-image prognosis assessment model was built by multifactor logistic regression analyses. Results: A total of 101 patients were enrolled in our study who acquired the correct etiological diagnosis based on the novel 3D-FLAIR MR combined with clinical examination. Among the 93 patients with unilateral SSNHL, 30.1% (28/93) showed labyrinthine abnormalities on 3D-FLAIR images. The severity of initial hearing loss in the MR+ group was worse than that in the MR− group (p < 0.05), and patients with positive MR findings tended to have poor recovery. An excellent prognostic model was built for hearing complete recovery and no recovery. The combination of three independent risk factors, including abnormal distortion products otoacoustic emission and transient evoked otoacoustic emission, the period from onset to treatment, and PTA at the onset, was adopted for hearing recovery/no recovery (accuracy = 90.2%, AUC = 0.820). Furthermore, adding the factor of positive MRI findings could improve the confidence for the judgment of hearing no recovery. The only independent risk factor, PTA at the onset, was adopted for complete/incomplete hearing recovery (accuracy = 86.1%, AUC = 0.874). Conclusion: The novel MR protocol had a good advantage in pathogenic diagnosis. Labyrinthine MR 3D-FLAIR signal abnormalities were related to the severity of an initial hearing loss and had a greater tendency to be found in patients with no recovery. A prognostic model with two main steps of unilateral SSNHL, mainly for SSNHL with no recovery and complete recovery, was built successfully and needed further verification by larger series of patients.

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Section: Discussionmentioning

confidence: 49%

Clinical Value of a Novel Magnetic Resonance Imaging Protocol and Prognostic Model Establishment for Sudden Sensorineural Hearing Loss: A Prospective Study

Wang

et al. 2022

Audiol Neurotol

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“…Te results indicate that the brain functional network of patients with sudden SHL tended to change to a regular network, and the ability of information integration was enhanced, while the ability of separation and transmission was weakened. All the above results confrm to some extent that the connection between auditory brain areas and language and vision-related functional areas was weakened in patients with burst SHL, and their language perception and understanding ability were decreased [27].…”

Section: Discussionmentioning

confidence: 52%

Analysis of Changes in Brain Region and Connectomics in the Acute Stage of Sudden Sensorineural Hearing Loss in the Resting State via Functional Magnetic Resonance Imaging

2023

Concepts in Magnetic Resonance Part A

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To explore the functional changes in the whole brain network in patients with sudden sensorineural hearing loss (SHL) at the acute stage from functional magnetic resonance imaging (fMRI) imaging evaluation results, 80 patients with sudden right SHL were selected as subjects (patient group). In addition, 40 healthy volunteers who underwent physical examination in the hospital during the same period were recruited as a control group. fMRI imaging was performed to analyze functional parameters and core nodes of the whole brain network. It was found that at all thresholds, the fMRI parameters Cp and Lp of the patient group were dramatically superior to those of the control group. The fMRI parameter Eglobal of the patient group was substantially lower than that of the control group ( P < 0.05 ). At most of the thresholds, the fMRI parameter λ in patients was dramatically superior to that in the control group ( P < 0.05 ). There were ten specific network core nodes in patients, including the right parahippocampal gyrus, right supra-occipital gyrus, left suboccipital gyrus, right fusiform gyrus, right parietal lobule, right subparietal lobule, right superior temporal gyrus, left superior marginal gyrus, and right superior temporal gyrus. In summary, the whole brains of patients with sudden SHL still had small-world attributes, but some characteristics of the brain network had changed, and there was a trend of transformation to a regular network. The connection between the auditory brain area and the functional areas related to language and vision was weakened, and the distribution of core nodes changed. This study provides a reference basis for exploring the changes in local brain and connectome levels in patients with sudden sensorineural hearing loss in the acute phase based on resting-state fMRI.

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“…Through clinical experience and literature study, we found that audiological examination, vestibular function and imaging tests are closely related to the prognosis of SSNHL. [9][10][11]…”

Section: Main Outcome Measuresmentioning

confidence: 99%

Thromboelastography predicting the prognosis of sudden sensorineural hearing loss

Chen

Wang

Gao

et al. 2022

Clinical Otolaryngology

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Clinical Value of 3D-FLAIR MRI in Idiopathic Sudden Sensorineural Hearing Loss

Cited by 6 publications

References 25 publications

Clinical Value of a Novel Magnetic Resonance Imaging Protocol and Prognostic Model Establishment for Sudden Sensorineural Hearing Loss: A Prospective Study

Clinical Value of a Novel Magnetic Resonance Imaging Protocol and Prognostic Model Establishment for Sudden Sensorineural Hearing Loss: A Prospective Study

Analysis of Changes in Brain Region and Connectomics in the Acute Stage of Sudden Sensorineural Hearing Loss in the Resting State via Functional Magnetic Resonance Imaging

Thromboelastography predicting the prognosis of sudden sensorineural hearing loss

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