Early Magnetic Resonance Imaging for Patients with Idiopathic Sudden Sensorineural Hearing Loss in an Emergency Setting

Research output: Contribution to journalArticle

Abstract

Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment. Study Design: Prospective observational study. Setting: Tertiary referral university center. Patients: Forty-seven patients (22 M, 25 F; age: 54.4 ± 17.5 yr) consecutively referred to the Department of Emergency for ISSHL. Interventions: All patients underwent the diagnostic and therapeutic work-up for ISSHL, and MR imaging within 72 hours from the admission, independently of the symptoms onset. All patients received the same treatment (systemic steroid therapy, intratympanic steroid injection, and hyperbaric oxygen therapy). Main Outcome Measure(s): MR patterns, clinical, and laboratory findings. Results: MR imaging was positive in 25 of 47 cases (53%), with a perfect agreement between clinical and MR examinations (Cohen K = 1) upon the affected ear. Three different radiological patterns were observed: labyrinthine haemorrhage (n = 5), acute inflammatory process (n = 14), isolated blood-labyrinth barrier breakdown (n = 6). By binary logistic regression, only vertigo was associated with a positive MR imaging [B = 2.8; p = 0.011; OR = 9.5 (95% CI: 2.2-40.8)] and the latter was the only variable associated with an unfavorable outcome [(B = 2.8; p = 0.02 OR = 12.8 (95% CI: 2.9-56.7)]. Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.

Original languageEnglish
Pages (from-to)1139-1147
Number of pages9
JournalOtology and Neurotology
Volume40
Issue number9
DOIs
Publication statusPublished - Oct 1 2019

Fingerprint

Sudden Hearing Loss
Sensorineural Hearing Loss
Emergencies
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Vertigo
Steroids
Hyperbaric Oxygenation
Inner Ear
Tertiary Care Centers
Observational Studies
Ear
Hospital Emergency Service
Therapeutics
Logistic Models
Outcome Assessment (Health Care)
Prospective Studies
Hemorrhage

Keywords

  • Ear
  • Emergency
  • Magnetic resonance imaging
  • Sudden hearing loss

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

@article{5976d34538e04429b35bd4ae7c75aa68,
title = "Early Magnetic Resonance Imaging for Patients with Idiopathic Sudden Sensorineural Hearing Loss in an Emergency Setting",
abstract = "Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment. Study Design: Prospective observational study. Setting: Tertiary referral university center. Patients: Forty-seven patients (22 M, 25 F; age: 54.4 ± 17.5 yr) consecutively referred to the Department of Emergency for ISSHL. Interventions: All patients underwent the diagnostic and therapeutic work-up for ISSHL, and MR imaging within 72 hours from the admission, independently of the symptoms onset. All patients received the same treatment (systemic steroid therapy, intratympanic steroid injection, and hyperbaric oxygen therapy). Main Outcome Measure(s): MR patterns, clinical, and laboratory findings. Results: MR imaging was positive in 25 of 47 cases (53{\%}), with a perfect agreement between clinical and MR examinations (Cohen K = 1) upon the affected ear. Three different radiological patterns were observed: labyrinthine haemorrhage (n = 5), acute inflammatory process (n = 14), isolated blood-labyrinth barrier breakdown (n = 6). By binary logistic regression, only vertigo was associated with a positive MR imaging [B = 2.8; p = 0.011; OR = 9.5 (95{\%} CI: 2.2-40.8)] and the latter was the only variable associated with an unfavorable outcome [(B = 2.8; p = 0.02 OR = 12.8 (95{\%} CI: 2.9-56.7)]. Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.",
keywords = "Ear, Emergency, Magnetic resonance imaging, Sudden hearing loss",
author = "Giorgio Conte and {Di Berardino}, Federica and Diego Zanetti and Iofrida, {Elisabetta Francesca} and Elisa Scola and Sara Sbaraini and Eliana Filipponi and Claudia Cinnante and Gaini, {Lorenzo Maria} and Umberto Ambrosetti and Fabio Triulzi and Lorenzo Pignataro and Pasquale Capaccio",
year = "2019",
month = "10",
day = "1",
doi = "10.1097/MAO.0000000000002389",
language = "English",
volume = "40",
pages = "1139--1147",
journal = "Otology and Neurotology",
issn = "1531-7129",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Early Magnetic Resonance Imaging for Patients with Idiopathic Sudden Sensorineural Hearing Loss in an Emergency Setting

AU - Conte, Giorgio

AU - Di Berardino, Federica

AU - Zanetti, Diego

AU - Iofrida, Elisabetta Francesca

AU - Scola, Elisa

AU - Sbaraini, Sara

AU - Filipponi, Eliana

AU - Cinnante, Claudia

AU - Gaini, Lorenzo Maria

AU - Ambrosetti, Umberto

AU - Triulzi, Fabio

AU - Pignataro, Lorenzo

AU - Capaccio, Pasquale

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment. Study Design: Prospective observational study. Setting: Tertiary referral university center. Patients: Forty-seven patients (22 M, 25 F; age: 54.4 ± 17.5 yr) consecutively referred to the Department of Emergency for ISSHL. Interventions: All patients underwent the diagnostic and therapeutic work-up for ISSHL, and MR imaging within 72 hours from the admission, independently of the symptoms onset. All patients received the same treatment (systemic steroid therapy, intratympanic steroid injection, and hyperbaric oxygen therapy). Main Outcome Measure(s): MR patterns, clinical, and laboratory findings. Results: MR imaging was positive in 25 of 47 cases (53%), with a perfect agreement between clinical and MR examinations (Cohen K = 1) upon the affected ear. Three different radiological patterns were observed: labyrinthine haemorrhage (n = 5), acute inflammatory process (n = 14), isolated blood-labyrinth barrier breakdown (n = 6). By binary logistic regression, only vertigo was associated with a positive MR imaging [B = 2.8; p = 0.011; OR = 9.5 (95% CI: 2.2-40.8)] and the latter was the only variable associated with an unfavorable outcome [(B = 2.8; p = 0.02 OR = 12.8 (95% CI: 2.9-56.7)]. Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.

AB - Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment. Study Design: Prospective observational study. Setting: Tertiary referral university center. Patients: Forty-seven patients (22 M, 25 F; age: 54.4 ± 17.5 yr) consecutively referred to the Department of Emergency for ISSHL. Interventions: All patients underwent the diagnostic and therapeutic work-up for ISSHL, and MR imaging within 72 hours from the admission, independently of the symptoms onset. All patients received the same treatment (systemic steroid therapy, intratympanic steroid injection, and hyperbaric oxygen therapy). Main Outcome Measure(s): MR patterns, clinical, and laboratory findings. Results: MR imaging was positive in 25 of 47 cases (53%), with a perfect agreement between clinical and MR examinations (Cohen K = 1) upon the affected ear. Three different radiological patterns were observed: labyrinthine haemorrhage (n = 5), acute inflammatory process (n = 14), isolated blood-labyrinth barrier breakdown (n = 6). By binary logistic regression, only vertigo was associated with a positive MR imaging [B = 2.8; p = 0.011; OR = 9.5 (95% CI: 2.2-40.8)] and the latter was the only variable associated with an unfavorable outcome [(B = 2.8; p = 0.02 OR = 12.8 (95% CI: 2.9-56.7)]. Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.

KW - Ear

KW - Emergency

KW - Magnetic resonance imaging

KW - Sudden hearing loss

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DO - 10.1097/MAO.0000000000002389

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