1262 Audit of MRI IAM (Internal Auditory Meatus) Requests at Darlington Memorial Hospital and Review of The Literature

Abstract

Abstract Aim To assess if the MRI IAM scans are being requested as suggested in NICE guidelines Draft 2017 for consultations. Educate and implement any changes if needed to minimise unnecessary investigations. Method Retrospective data collection of 1000 data. Variables included hearing loss (HL), tinnitus (T), dizziness (D) and other lateralized symptoms. Audiograms assessed for asymmetrical HL at decibel level ≥20 Db at a frequency of 0.5 kHz, 1.0 kHz, 2.0 kHz. MRI of IAM assessed if a cerebellar pontine angle (CPA) lesion was presented. Results 853 (85.3%) met criteria. 16/1000 (1.6%) MRI showed CPA lesion. All 16 cases had unilateral sensorineural hearing loss (SNHL) and met NICE guidelines criteria. Discussion Limited value in the scanning of asymptomatic patients, those who do not fit audiometric guidelines, those bilateral symptoms or those with unilateral tinnitus without audiometric asymmetry. Very few studies were found in the literature in relation to symptoms associated with positive findings of CPA lesion. Our results indicate unilateral SNHL were linked with positive findings of MRI and it is similar findings in the literature. We recommend that patients who present with asymmetrical SNHL with this audiometric asymmetrical characteristic of 20Db or more will need an urgent MRI IAM as part of their diagnostic workup.