Prognostic Value of Labyrinthine 3D-FLAIR Abnormalities in Idiopathic Sudden Sensorineural Hearing Loss

Lee, J.I.; Yoon, Ra Gyoung; Lee, J.H.; Park, J.W.; Yoo, Myung Hoon; Ahn, Joong Ho; Chung, Juyong; Park, H.J.

doi:10.3174/ajnr.a4901

Cited by 33 publications

(48 citation statements)

References 17 publications

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“…Our finding of AN in 20 (2.4%) of 848 patients with SSNHL is consistent with these reports. Although the specific audiogram configuration of AN was not described in previous studies [Jeong et al, 2016;Lee, et al, 2016;Stachler et al, 2012], there have been some reports of trough-shaped audiograms in patients with AN presenting with SSNHL [Ogawa et al, 1991;Sakata et al, 1991]. The authors of those studies mentioned that a trough-type audiogram configuration was common in patients with AN presenting as SSNHL but did not report the numbers of patients with SSNHL characterized by a trough-shaped audiogram.…”

Section: Discussionmentioning

confidence: 81%

“…Although there have been numerous reports of patients with AN and SSNHL [Jeong et al, 2016;Lee et al, 2016;Saunders et al, 1995;Stachler et al, 2012;Yanagihara et al, 1993], the prevalence of SSNHL in patients with AN is unclear. According to Saunders et al [1995], more than a quarter of patients with AN will experience an episode of SSNHL during the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

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Trough-Shaped Audiograms Are Common in Patients with Acoustic Neuroma and Sudden Sensorineural Hearing Loss

Hosokawa

Takebayashi

et al. 2018

Audiol Neurotol

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Acoustic neuroma sometimes presents with sudden-onset sensorineural hearing loss as a primary symptom. We investigated 848 untreated cases that included 20 cases with acoustic neuroma with sudden-onset sensorineural hearing loss and 828 cases without acoustic neuroma. Fourteen of the 20 acoustic neuroma and 90 of the 828 cases of sudden-onset sensorineural hearing loss showed a trough-shaped audiogram with the greatest amount of hearing loss in the mid-frequency range. The incidence of a trough-shaped audiogram was significantly higher in patients with acoustic neuroma than in those without (p < 0.01). This study suggests that a trough audiogram is a significant finding in patients with sudden-onset sensorineural hearing loss and indicates the presence of acoustic neuroma.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Trough-Shaped Audiograms Are Common in Patients with Acoustic Neuroma and Sudden Sensorineural Hearing Loss

Hosokawa

Takebayashi

et al. 2018

Audiol Neurotol

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“…In 62% of these patients with a positive 3D‐FLAIR, contrast enhancement was seen, indicative of a breakage of the blood‐labyrinth barrier (Table ). In only two patients, reported in two different studies, pre‐ and post‐contrast T1‐weighted images were positive in addition to high signal intensity on 3D‐FLAIR suggesting labyrinthine haemorrhage with blood‐labyrinth breakdown . These two patients were included in the ILH group (Table ).…”

Section: Resultsmentioning

confidence: 96%

“…In a total of 638 patients, pre‐contrast 3D‐FLAIR images were obtained of which 29% (n = 186) revealed high signal intensity in the labyrinth (Table ). In seven of the eight studies, data were also available on post‐contrast 3D‐FLAIR and/or T1‐weighted imaging . Contrast enhancement was found in 96 of 518 patients (19%).…”

Section: Resultsmentioning

confidence: 99%

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The prognostic value and pathophysiologic significance of three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging in idiopathic sudden sensorineural hearing loss: A systematic review and meta‐analysis

Lammers

Young

Fenton

et al. 2019

Clinical Otolaryngology

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Background The underlying pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown. However, an increasing number of observational studies report intralabyrinthine signal alterations in patients with ISSNHL using three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging (MRI). These findings warrant a meta‐analysis. Objective of review To conduct a meta‐analysis assessing the value of 3D‐FLAIR MRI in identifying possible underlying labyrinthine pathophysiologic mechanisms and prognostication in patients with ISSNHL. Search strategy Two reviewers independently searched the Pubmed, Embase and Cochrane Library from inception until October 10, 2018 and evaluated eligibility based on titles and abstracts of all retrieved studies. All studies reporting on 3D‐FLAIR imaging in ISSNHL were included. Subsequently, the full text of eligible studies were evaluated. Evaluation method Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias and evaluated the relevance and quality of evidence. Data on the number of patients and events were extracted and hearing levels were converted to standardised mean differences (SMD) for conducting meta‐analyses. Random effects models for meta‐analyses were applied. Results Eight observational studies met our inclusion criteria (n = 638 patients). In 29%, high signal intensity was found on 3D‐FLAIR imaging, suggesting labyrinthine pathology (labyrinthitis [79%], intralabyrinthine haemorrhage [21%]). High signal intensity on 3D‐FLAIR was associated with poorer hearing (SMD: 14 dB, 95% CI 5.67‐22.94) and vertigo (RR: 1.92, 95% CI 1.16‐3.17) at baseline. Multivariate analyses demonstrated that patients with high 3D‐FLAIR signal intensity had 21 dB lower final hearing pure‐tone averages (SMD: 21 dB, 95% CI 9.08‐33.24). Conclusions Three‐dimensional fluid‐attenuated inversion recovery MR imaging can identify an underlying labyrinthine condition in up to 29% of patients with sudden hearing loss in whom previously no cause could be identified. Their final pure‐tone averages are more than 20 dB worse than 3D‐FLAIR–negative patients, suggesting more severe labyrinthine damage. Findings such as these may contribute to our understanding of pathophysiologic mechanisms of ISSNHL.

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T2 relaxation time shortening in the cochlea of patients with sudden sensory neuronal hearing loss: a retrospective study using quantitative synthetic magnetic resonance imaging

et al. 2021

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Prognostic Value of Labyrinthine 3D-FLAIR Abnormalities in Idiopathic Sudden Sensorineural Hearing Loss

Cited by 33 publications

References 17 publications

Trough-Shaped Audiograms Are Common in Patients with Acoustic Neuroma and Sudden Sensorineural Hearing Loss

Trough-Shaped Audiograms Are Common in Patients with Acoustic Neuroma and Sudden Sensorineural Hearing Loss

The prognostic value and pathophysiologic significance of three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging in idiopathic sudden sensorineural hearing loss: A systematic review and meta‐analysis

T2 relaxation time shortening in the cochlea of patients with sudden sensory neuronal hearing loss: a retrospective study using quantitative synthetic magnetic resonance imaging

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