Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Laryngoscope. 2023 Mar;133(3):670-675. doi: 10.1002/lary.30230. Epub 2022 May 28.
To investigate the likelihood of missing a vestibular schwannoma (VS) diagnosis in patients who present with a sudden hearing loss (SHL) that does not meet the most accepted audiometric criteria for sudden sensorineural hearing loss (SSNHL) (a decrease of ≥30 dB at three consecutive frequencies).
All adult patients (>18 years) diagnosed with SHL of any severity in a tertiary care referral medical center between 2015 and 2020 and who underwent an MRI scan to rule out VS were included. Statistical analyses were conducted to evaluate the difference between the rate of VS among patients with an initial audiogram, which met the abovementioned criteria, and those who did not. Other audiometric criteria for SNHL were also evaluated (≥10 dB at ≥2 frequencies and ≥ 15 dB at one frequency).
Of the 332 patients included in the study, 152 met the audiometric criteria for SSNHL, and 180 did not. Both groups had a similar VS rate (8.6% vs. 8.9%, p = 0.914). Similar results were found when other audiometric criteria for asymmetric SNHL were analyzed. In a subgroup analysis of patients with VS-associated SSNHL, neither the tumor size nor the Koos classification was associated with any of the audiometric criteria systems.
There should be a high index of suspicion for the presence of VS in patients with an SHL of any severity.
3 Laryngoscope, 133:670-675, 2023.
研究在未满足突发性聋（SSNHL）最公认的听力学标准（连续三个频率下降≥30dB）的突发性听力损失（SHL）患者中，漏诊前庭神经鞘瘤（VS）的可能性。
纳入 2015 年至 2020 年在一家三级医疗转诊中心诊断为任何严重程度 SHL 的所有成年患者（>18 岁），并进行 MRI 扫描以排除 VS。统计分析用于评估初始听力图符合上述标准的患者和不符合标准的患者之间 VS 发生率的差异。还评估了其他 SNHL 的听力学标准（≥2 个频率≥10dB，一个频率≥15dB）。
在纳入研究的 332 名患者中，有 152 名符合 SSNHL 的听力学标准，180 名不符合。两组的 VS 发生率相似（8.6% vs. 8.9%，p=0.914）。当分析非对称 SNHL 的其他听力学标准时，也得到了类似的结果。在伴有 VS 的 SSNHL 患者的亚组分析中，肿瘤大小或 Koos 分级与任何听力学标准系统均无关。
对于任何严重程度的 SHL 患者，均应高度怀疑 VS 的存在。
3 级喉镜，133：670-675，2023。
