The clinical value of 4‐hour delayed‐enhanced 3D‐FLAIR MR images in sudden hearing loss

Byun, Hayoung; Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Park, Dong Woo; Kim, Tae Yoon

doi:10.1111/coa.13305

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…Kim et al (36) also showed no significant difference in signal intensity in the affected ears. However, Byun et al (37) and Min et al (38) suggested that the higher signal intensity observed in ISSNHL patients 4 h after Gd indicated a poor prognosis. Byun et al (37) claimed that a higher signal intensity was shown in 4-h Gd-injection imaging than that in 10-min imaging.…”

Section: Discussionmentioning

confidence: 99%

“…However, Byun et al (37) and Min et al (38) suggested that the higher signal intensity observed in ISSNHL patients 4 h after Gd indicated a poor prognosis. Byun et al (37) claimed that a higher signal intensity was shown in 4-h Gd-injection imaging than that in 10-min imaging. The increased signal intensity caused by increased permeability (due to BLB) suggested an increase in inner ear damage.…”

Section: Discussionmentioning

confidence: 99%

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Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion

Qin

et al. 2021

Front. Surg.

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Objective: The aim of this study is to evaluate the possible value of endolymphatic hydrops (EH) in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL) with four types according to audiometry.Methods: Seventy-two patients (40 men and 32 women; age range, 28–78 years; mean age: 50.0 ± 12.9 years) with UISSNHL were admitted retrospectively into this study. Based on the pure tone audiometry before treatment, the hearing loss of all these patients were categorized into four types: low-frequency group (LF-G), high-frequency group (HF-G), flat group (F-G), and total deafness group (TD-G). The average time from symptom onset to the first examination was 6.9 ± 4.4 days (1–20 days). 3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium (Gd) within 1 week after the UISSNHL onset. The incidence of EH in the affected ears based on four types of hearing loss were analyzed using the Chi-square test, and the possible relationship with vertigo and prognosis were also assessed.Results: Eleven of 21 patients (52.4%) in LF-G had the highest EH-positive rate, followed by 18.2% in HF-G, 11.8% in F-G, and 17.4% in TD-G. The significant difference was found in the four groups (P = 0.018). The EH rate of LF-G was statistically significantly higher than that of F-G and TD-G (P = 0.009, P =0.014), respectively. After being valued by the volume-referencing grading system (VR scores), the EH level was represented by the sum scores of EH. In LF-G, no statistically significant difference was found in the prognosis of ISSNHL patients between with the EH group and the no EH group (P = 0.586). The symptom “vertigo” did not correlate with EH and prognosis.Conclusions: EH was observed in UISSNHL patients by 3D-FLAIR MRI. EH may be responsible for the pathology of LF-G but not related to prognosis. It might be meaningless to assess EH in other hearing loss types, which might be more related to the blood-labyrinth dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion

Qin

et al. 2021

Front. Surg.

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“…There have been numerous studies of the prognostic factors for ISSNHL. [13][14][15] One study reported that hearing outcomes were poorer in subjects presenting late and in those with associated diabetes or hypertension. 9 Another study suggested that prognostic factors were age, initial hearing threshold, speech performance scores before treatment, descending-type audiogram, and coexistence of tinnitus.…”

Section: Discussionmentioning

confidence: 99%

“…There have been numerous studies of the prognostic factors for ISSNHL 13–15 . One study reported that hearing outcomes were poorer in subjects presenting late and in those with associated diabetes or hypertension 9 .…”

Section: Discussionmentioning

confidence: 99%

Effect of Diabetes on the Prognosis of Sudden Sensorineural Hearing Loss: Propensity Score Matching Analysis

Seo

Chung

Byun

et al. 2020

Otolaryngol.--head neck surg.

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Objective The aim of this study was to investigate the clinical implications of diabetes for the management of idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design Retrospective study. Setting Tertiary referral center. Subjects and Methods ISSNHL patients (N = 403) who received inpatient management between January 2015 and December 2018 were analyzed. All were managed by a uniform treatment protocol of high-dose steroid therapy and salvage intratympanic steroid injections. Treatment results were evaluated according to the American Academy of Otolaryngology—Head and Neck Surgery’s criteria 3 months after the start of treatment. We compared the clinical parameters and treatment outcomes of ISSNHL with and without diabetes. We also evaluated the influence of diabetes on the prognosis of ISSNHL by propensity score matching. Results Overall, of the 403 ISSNHL patients, 94 (23.3%) had diabetes, and 11 were newly diagnosed with diabetes. The patients with diabetes were older than those without diabetes ( P < .001), and their initial hearing threshold was significantly higher ( P < .001). The diabetic patients were hospitalized for a longer period, and their hearing recovery rate was lower. However, when age, sex, and initial hearing level were adjusted by propensity score matching, the diabetic patients and matched controls yielded similar treatment results. Conclusions ISSNHL with diabetes usually presents with severe hearing loss and requires longer hospitalization. However, diabetes itself may not influence the prognosis of ISSNHL. Proper management must be provided in ISSNHL with diabetes.

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“…Meanwhile, post-contrast 3D FLAIR MRI findings showed high sensitivity and encouraging prognostic value in several studies. 20,21) An enhancement in the post-contrast 3D FLAIR MRI can demonstrate loosening of the BLB. Although both pre-contrast 3D FLAIR MRI and post-contrast 3D FLAIR MRI can reflect on the integrity of BLB, care should be taken to differentiate between them since the visualized pathology is different.…”

Section: Discussionmentioning

confidence: 99%

3D FLAIR Cochlear Abnormality Does Not Predict on Sudden Sensorineural Hearing Loss Prognosis: A Retrospective Cohort Study

Shin¹,

Cho²,

Jeong³

et al. 2022

Korean J Otorhinolaryngol-Head Neck Surg

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Background and Objectives Previous studies reported abnormalities in MRI as a poor prognostic indicator of sudden sensorineural hearing loss (SSNHL). Since abnormalities in three-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) are strongly correlated with the initial hearing function, the prognostic value of the 3D FLAIR images should be carefully evaluated to avoid collinearity. We aimed to evaluate abnormalities on the 3D FLAIR images as an independent prognostic factor in the matched SSNHL groups. Subjects and MethodWe retrospectively reviewed medical records of 179 patients with SSNHL who underwent temporal MRI, including the 3D FLAIR sequence, between January 2015 and December 2019. Patients were divided based on the presence of cochlear abnormalities on the 3D FLAIR images. Hearing prognosis was evaluated with and without matching for initial hearing and treatment interval. Results The groups were similar in sex (p=0.091), age (p=0.925), treatment interval (p= 0.216), and MRI interval (p=0.828). Notably, patients with cochlear abnormalities on the 3D FLAIR images showed distinctly more severe hearing loss (p<0.001) at the initial pure tone average (PTA) assessment and poorer outcomes (p<0.001) compared to those without abnormality. After matching for initial hearing and treatment interval, the hearing outcome, measured by PTA, was similar between the groups (p=0.681). Conclusion Cochlear signal abnormality in 3D FLAIR MRI was associated with poor initial hearing. However, it did not affect hearing recovery outcomes when the groups were matched.

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The clinical value of 4‐hour delayed‐enhanced 3D‐FLAIR MR images in sudden hearing loss

Cited by 20 publications

References 19 publications

Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion

Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion

Effect of Diabetes on the Prognosis of Sudden Sensorineural Hearing Loss: Propensity Score Matching Analysis

3D FLAIR Cochlear Abnormality Does Not Predict on Sudden Sensorineural Hearing Loss Prognosis: A Retrospective Cohort Study

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