Baird Samantha M, Nguyen Kevin, Bhatia Daman D S, Wei Benjamin P C
Department of Otolaryngology, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Department of Otolaryngology, The University of Melbourne, Melbourne, Victoria, Australia.
ANZ J Surg. 2019 Jun;89(6):738-742. doi: 10.1111/ans.14957. Epub 2018 Nov 29.
In sudden and asymmetrical progressive sensorineural hearing loss (SNHL), magnetic resonance imaging (MRI) is required to evaluate retrocochlear pathology and, with recent advances in MRI techniques, inner ear pathology. Given the limited literature regarding inner ear pathology associated with SNHL, we aimed to assess the incidence of retrocochlear and inner ear pathology, and congenital malformation on MRI in sudden SNHL (SSNHL) and progressive SNHL.
A total of 987 acoustic neuroma (AN) protocol MRI internal acoustic meatus studies performed at our institution to investigate SNHL between January 2013 and December 2015 inclusive were identified. Following categorization for indication of SSNHL versus progressive asymmetrical SNHL, MRIs with retrocochlear or inner ear abnormality, congenital malformation or other otology-related abnormality were identified, and further data were collected for these patients including patient demographics, associated symptomatology, management and outcomes.
In SSNHL, aetiological abnormality on MRI was identified for 6.9% patients with AN present on 4% overall. 3.2% of MRIs for progressive asymmetrical SNHL identified a causative lesion with 2.3% of scans overall diagnosing AN. The incidence of congenital inner ear malformation on MRI in the setting of SSNHL and progressive asymmetrical SNHL are 1.7% and 0.6%, respectively.
This is the first retrospective study of inner ear MRI abnormalities in both SSNHL and progressive asymmetrical SNHL in Australia and one of the largest cohorts published in the literature to date. MRI must be performed in the setting of SNHL to ensure aforementioned and rarer causative lesions are identified.
在突发性非对称性进行性感音神经性听力损失（SNHL）中，需要进行磁共振成像（MRI）来评估蜗后病变，并且随着MRI技术的最新进展，还可用于评估内耳病变。鉴于关于与SNHL相关的内耳病变的文献有限，我们旨在评估突发性SNHL（SSNHL）和进行性SNHL中蜗后和内耳病变以及MRI上先天性畸形的发生率。
确定了2013年1月至2015年12月在我们机构进行的987例听神经瘤（AN）方案的内耳道MRI研究，以调查SNHL。在将其分类为SSNHL与进行性非对称性SNHL的指征后，识别出具有蜗后或内耳异常、先天性畸形或其他耳科相关异常的MRI，并为这些患者收集进一步的数据，包括患者人口统计学、相关症状、治疗和结果。
在SSNHL中，6.9%的患者在MRI上发现病因异常，总体上4%的患者存在AN。进行性非对称性SNHL的MRI中有3.2%发现了致病病变，总体扫描中有2.3%诊断为AN。在SSNHL和进行性非对称性SNHL情况下，MRI上先天性内耳畸形的发生率分别为1.7%和0.6%。
这是澳大利亚对SSNHL和进行性非对称性SNHL中内耳MRI异常的首次回顾性研究，也是迄今为止文献中发表的最大队列之一。在SNHL的情况下必须进行MRI检查，以确保识别上述及更罕见的致病病变。
