Clinical Thresholds for When to Test for Retrocochlear Lesions: Pro

Cueva, Roberto A.

doi:10.1001/archoto.2010.101

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…The criteria for assessing abnormal responses on ABR tests have varied considerably among studies. Some authors argue that the ABR has no place in today's management and that MRI should be the initial screening test when there is a suspicion of VS [ 18 ]. Other authors argue that there is still a place for the ABR in the diagnostic algorithm due to the high cost and lower availability of MRI [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

Audiovestibular Function Deficits in Vestibular Schwannoma

Kirschbaum¹,

Gürkov²

2016

BioMed Research International

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Introduction. Vestibular schwannomas (VS) are benign tumours of the vestibular nerve and can lead to hearing loss, tinnitus, vertigo, facial palsy, and brainstem compression. Audiovestibular diagnostic tests are essential for detection and treatment planning. Methods. Medline was used to perform a systematic literature review with regard to how audiovestibular test parameters correlate with symptoms, tumour size, and tumour location. Results. The auditory brainstem response can be used to diagnose retrocochlear lesions caused by VS. Since hearing loss correlates poorly with tumour size, a retrocochlear lesion is probably not the only cause for hearing loss. Also cochlear mechanisms seem to play a role. This can be revealed by abnormal otoacoustic emissions, despite normal ABR and new MRI techniques which have demonstrated endolymphatic hydrops of the inner ear. Caloric and head impulse tests show frequency specific dynamics and vestibular evoked myogenic potentials may help to identify the location of the tumour regarding the involved nerve parts. Conclusion. In order to preserve audiovestibular function in VS, it is important to stop the growth of the tumour and to avoid degenerative changes in the inner ear. A detailed neurotological workup helps to diagnose VS of all sizes and can also provide useful prognostic information.

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Section: Resultsmentioning

confidence: 99%

Audiovestibular Function Deficits in Vestibular Schwannoma

Kirschbaum¹,

Gürkov²

2016

BioMed Research International

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“…11 Cost analyses have shown that ABR-MRI screening algorithms may not be cost-effective owing to the high false-negative rate of ABR and should be abandoned. 7,11 However, ABR testing may be useful in certain clinical scenarios, such as in older patients in whom the missed diagnosis of a small tumor may be less consequential or if an MRI is contraindicated owing to the presence of metallic implants (eg, pacemakers, aneurysm clips). 12,15 A recent meta-analysis evaluating the use of ABR testing in diagnosing VS noted high sensitivity and specificity (pooled sensitivity of 95.6% for tumors >1 cm and 85.8% for tumors <1 cm).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical criteria used to perform the MRI and criteria previously reported to be associated with retrocochlear disease were recorded, including the degree and type of ASNHL, "acute" (<72 hours) onset of symptoms, unilateral tinnitus, bilateral tinnitus, and generalized disequilibrium or vertigo. 1,6,7 This retrospective medical record review was approved by the Henry Ford Hospital institutional review board, which waived participant written informed consent.…”

Section: Methodsmentioning

confidence: 99%

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

Ahsan

Standring

Osborn

et al. 2015

JAMA Otolaryngol Head Neck Surg

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“…1 However, not all cases of asymmetrical sensorineural hearing loss (SNHL) have retro-cochlear pathology and till date debate still exists among researchers regarding the use of MRI in all the cases presenting as asymmetrical SNHL. [1][2][3][4] MRI as an expensive imaging technique should have an effective utilization strategies to minimize the rising imaging-related health care costs. 4,5 The MRI referral rates by general practitioners are increasing to audiology departments, which may have a significant impact on service provision.…”

Section: Introductionmentioning

confidence: 99%

Role of MRI in audio-vestibular dysfunction; is it cost-effective?

Albarki

Hudise

Malik

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Till date, debate still exists among researchers regarding the use of magnetic resonance imaging (MRI) in all the cases presenting as asymmetrical sensorineural hearing loss (SNHL). The objective of the study was to investigate cost-effectiveness of MRI for evaluating patients with audiovestibular symptoms. Methods: A retrospective study was carried out included all adult patients (>12 years) presenting over a 12 month period between November 2014 and October 2015 at Otolaryngology department clinic, Armed Forces Hospital. Khamis Mushait, Saudi Arabia with asymmetrical sensorineural hearing loss (sudden or progressive) and have underwent MRI of cerebellopontine angle and internal auditory meati for evaluation of audiovestibular symptoms. Results: The study included 52 patients with audiovestibular symptoms. Their mean age (±SD) was 46 (±13.9) years and almost two-thirds of them (65.4%) were males. Majority of them were presented with deafness (84.6%). Vertigo and tinnitus were presented in 38.5% and 53.8% of them, respectively. Over the studied 52 patients, MRI of cerebellopontine angle yielded no detectable lesion in any case. Conclusions: MRI was not cost-effective, so it is important that clinical and audiometric indications for MRI referral criteria should be reviewed and analyzed to ensure cost-effectiveness of MRI in detecting audiovestibular dysfunctions, particularly in situations with financial restraints and long waiting time.

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Clinical Thresholds for When to Test for Retrocochlear Lesions: Pro

Cited by 9 publications

References 22 publications

Audiovestibular Function Deficits in Vestibular Schwannoma

Audiovestibular Function Deficits in Vestibular Schwannoma

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

Role of MRI in audio-vestibular dysfunction; is it cost-effective?

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