Anatomical and Pathological Findings of Magnetic Resonance Imaging in Idiopathic Sudden Sensorineural Hearing Loss

Abstract

Background and Objectives: We sought to evaluate the diagnostic and prognostic value of measurable parameters of internal auditory canal (IAC) magnetic resonance imaging (MRI) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).Subjects and Methods: We retrospectively reviewed the patients with ISSNHL who underwent IAC MRI from January 2008 to March 2019. Measurable parameters of IAC MRI, such as the diameter of the IAC, bony cochlear nerve canal, and cross-sectional area of the cochlear nerve, were measured by a single examiner. These parameters were then compared between the affected and healthy sides. Inner-ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis were also evaluated. The relationship between the surveyed parameters and the diagnosis of ISSNHL was assessed.Results: A total of 208 patients with ISSNHL were included. The measured parameters of IAC MRI were not different between the affected and healthy sides and were also not associated with the diagnosis of ISSNHL. However, inner-ear abnormalities of IAC MRI in ISSNHL displayed a significant association with worse hearing before and after treatment. An age that was older than 40 years also correlated with poorer outcomes. Further, inner-ear abnormalities were more frequently detected when IAC MRI was performed early after ISSNHL onset.Conclusions: Patients with ISSNHL and inner ear abnormalities such as intralabyrinthine hemorrhage or labyrinthitis identified via IAC MRI may experience poorer hearing outcomes. To detect such abnormal findings, it is recommended to perform IAC MRI early after the onset of ISSNHL.

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

“…About 90% of patients with SSNHL have no identifiable cause for the hearing loss ( 1 ). Rather than the possible tumor, trauma, or other causes identifiable according to patients' history ( 2 ), the exact etiology and pathological mechanism of idiopathic sudden sensorineural hearing loss (ISSNHL) have not been clarified ( 3 ). Hypothesis causes of ISSNHL mainly focused on micro-circulation disorders, viral infection, or autoimmune diseases ( 3 ).…”

“…Rather than the possible tumor, trauma, or other causes identifiable according to patients' history ( 2 ), the exact etiology and pathological mechanism of idiopathic sudden sensorineural hearing loss (ISSNHL) have not been clarified ( 3 ). Hypothesis causes of ISSNHL mainly focused on micro-circulation disorders, viral infection, or autoimmune diseases ( 3 ). However, the possible relationship between EH and hearing loss was also mentioned early in 2002 ( 4 ); however, few articles published to support due to the limited imaging techniques.…”

The importance of the timing of magnetic resonance imaging in detecting the etiology of sudden hearing loss

“…Aynı zamanda MRG ile tespit edilen bulguların prognozu takip etmede kullanılabileceği bildirilmiştir. [12] Conte ve ark. [13] ani işitme kayıplı hastalarda ilk 72 saat içinde MRG yaptıkları çalışmada; erken MRG sonuçları ile idiyopatik AİK'nin akut/subakut fazında iç kulak yapılarında meydana gelen patolojik değişikliklerin daha iyi anlaşılabileceğini ve yakın gelecekte mevcut tedavilere bakış açısını geliştirebileceğini ileri sürmüşlerdir.…”

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

“…24 The disappearance of their inner cochlea to a high signal ranged from 3 to 6 months after their onset. 25 The guidelines for diagnosis and treatment of sudden deafness in my country do not recommend noisy examinations (such as MRI and ABR) within 1 week of onset. 26 Therefore, the MR examination time in this study was at least 7 days after the onset of the disease.…”

“…ISSNHL patients may often be accompanied by idiopathic inner ear bleeding . The disappearance of their inner cochlea to a high signal ranged from 3 to 6 months after their onset . The guidelines for diagnosis and treatment of sudden deafness in my country do not recommend noisy examinations (such as MRI and ABR) within 1 week of onset .…”