Unilateral sensorineural hearing loss: Analysis of 200 consecutive cases

Abstract

The spectrum of diseases diagnosed and the protocol used in the investigation of 200 consecutive patients with unilateral sensorineural hearing loss (SNHL) is presented. The diagnostic tests found most useful in defining the site of the lesion were a combination of a well-masked pure tone audiogram, speech discrimination score (SDS), acoustic reflex test (ART), and a vestibular evaluation using photoelectric nystagmography (PENG) and the Torok Monothermal Differential Caloric Test. With this protocol, the site of the lesion was correctly defined in 94% of patients with unilateral progressive SNHL. Laboratory and radiological studies confirmed a variety of lesions other than acoustic tumors. It is, therefore, felt that the primary objective of investigations should be to define the site of the lesion rather than aim to diagnose a specific disease entity.

Case report: Acute audiovestibular presentation following hemi-pontine infarction

“…SSNHL that is unilateral and isolated or when accompanied by vertigo is often attributed to labyrinthitis (a rare condition) (Barkwill and Arora, 2023). Hearing loss resulting from neural lesions, including the auditory nerve and central auditory pathway lesions (cochlear nuclei to the temporal cortex), is less frequent (Kumar et al, 1986). The anatomical limits of the infarcted region within the pons dictate the clinical syndrome, and among its various clinical presentations, cerebrovascular infarction of the central auditory pathways has been described infrequently (Muttikkal et al, 2014).…”

Accelerated Internal Auditory Canal Screening Magnetic Resonance Imaging Protocol With Compressed Sensing 3-Dimensional T2-Weighted Sequence

“…Targeted MRI sequences of the internal auditory canal (IAC) are often added to MRI protocols for patients that present with sensorineural hearing loss (SNHL) or dizziness. Vestibular schwannomas are the most frequently detected lesion 1,2 , yet such screening evaluations have low yield with only 3–5% revealing a detectable underlying mass or lesion 3 . Contrast-enhanced T1-weighted MRI is considered the gold-standard for diagnosing abnormalities in the cerebellopontine angle (CPA) and IAC, particularly for lesions below 2-mm in size at or near Scarpa’s ganglion 4 .…”

Diagnostic Accuracy of Screening MR Imaging Using Unenhanced Axial CISS and Coronal T2WI for Detection of Small Internal Auditory Canal Lesions

“…1,2 Nevertheless, only 2.7%-4.7% of contrast-enhanced MRIs performed for audiovestibular symptoms will diagnose vestibular schwannomas. 3,4 Although gadolinium-enhanced thin section MR imaging has historically been considered the "gold standard" for detection of internal auditory canal (IAC) tumors such as vestibular schwannomas, lower cost unenhanced, fluid-sensitive sequences have demonstrated pooled sensitivities ranging from 96% to 98% for detection of IAC lesions ranging from 2 mm to Ͼ20 mm in diameter.…”