Correlation of Clinical Factors and Audiometric Characteristics with MRI Findings in Patients with Asymmetric Sensorineural Hearing Loss

Quynh-Nhu Vu,Ellen Ko,Hannah Laur,Garrett Carpenter,Samuel J Wisniewski,Carl Shermetaro

doi:10.51894/001c.7005

Abstract

CONTEXTTo identify the presence of any correlative factors between presenting symptoms and characteristics of asymmetrical sensorineural hearing loss on audiogram, and if retrocochlear pathology was identified on MRI in patients presenting in a private practice setting.METHODSA retrospective study of patients meeting inclusion criteria who underwent MRI for asymmetric hearing loss between March 2014 to March 2017 was reviewed using Allscripts electronic health records. This data was then compiled in an excel spreadsheet and submitted for statistical analysis.RESULTSOf the initial 687 study patients, N = 303 patients met the inclusion criteria for review. Of these 303, 48 patients (15.8%) had abnormal MRI findings. Chi-square analysis performed showed no significant association of varied clinical variables (e.g. uni and bi-lateral tinnitus, vertigo, etc.) with abnormal MRI. Point Biserial Correlation analysis revealed no statistically significant correlations, with the exception of that between AS (Left Ear) 6 kHz and MRI lesions (r = -0.115, p = 0.045). Logistic and multinomial logistic regression analysis used to calculate odds ratios showed that for patients with hearing loss at the 6 kHz (dB) level, there is a very slightly lower, statistically significant likelihood of lesions showing up on MRI (OR, 0.984 (95% CI, 0.970-0.998), p = 0.0251).CONCLUSIONSThe results lead to the conclusion that there may be an association between experiencing hearing loss at the level of 6 kHz and a slightly lower chance of the presence of retrocochlear lesion noted on MRI.

Highlights

When a patient presents with asymmetrical sensorineural hearing loss, a variety of etiologies must be considered
Many otolaryngologists will consistently order magnetic resonance imaging (MRI) to rule out intracranial tumors out of concern for medicolegal reasons, even though a majority of these scans will return negative for a retrocochlear cause of the asymmetric hearing loss.[3]
The goal of this study was to retrospectively identify the presence of any correlative factors between presenting symptoms and characteristics of asymmetrical sensorineural hearing loss on audiogram, and whether or not retrocochlear pathology was identified on MRI in patients presenting in a private practice setting

Summary

Introduction

When a patient presents with asymmetrical sensorineural hearing loss, a variety of etiologies must be considered. Many otolaryngologists will consistently order MRI to rule out intracranial tumors out of concern for medicolegal reasons, even though a majority of these scans will return negative for a retrocochlear cause of the asymmetric hearing loss.[3]. Vestibular schwannoma, called acoustic neuroma, is the most common tumor of the cerebellopontine angle (located between the cerebellum and pons) and often presents with unilateral or asymmetric sensorineural hearing loss (Figure 1).[5] Other symptoms may present in association, including imbalance and tinnitus,[5] these symptoms are often absent in up to 45% patients diagnosed with acoustic neuroma.[2]

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