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

Abstract

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.

Thromboelastography predicting the prognosis of sudden sensorineural hearing loss

“…Inner ear MRI abnormalities include inner ear haemorrhage, protein deposition and BLB‐B. This is usually due to haemorrhage or inflammation 22,23 . This study found no correlation between TEG and inner ear MRI.…”

“…This is usually due to haemorrhage or inflammation. 22,23 This study found no correlation between TEG and inner ear MRI. In patients with normal MRI, TEG hypercoagulation and hypocoagulation were found in 32% and 8% of patients, respectively, and in patients with abnormal MRI results, TEG hypercoagulation and hypocoagulation were found in 44.2% and 7.7% of patients, respectively.…”

Cochlear Obliteration after Translabyrinthine Resection for Large Cerebellopontine Angle Tumor

“…This theory explains why full IAC involvement of tumor is a risk factor of cochlear obliteration. Labyrinthine hemorrhage is another possible cause of cochlear obliteration and can be detected by abnormal hyperintense signal in pre-contrast T1W or FLAIR MRI [Vakkalanka et al, 2000;Chen et al, 2019]. High signal intensity on T1W image is probably caused by intracellular methemoglobin or protein macromolecule deposition following erythrocyte destruction.…”

Does Chronic Immune Thrombocytopenia Lead to Hearing Loss?

“…As a result of the widespread use of Magnetic Resonance Imaging (MRI) acute sensorineural hearing loss (SNHL) due to hemorrhage in inner ear has been reported in the literature [16]. Also, especially in patients with underlying coagulation disorders, cases of SNHL as a result of ILH have been reported [17,18].…”