MR Imaging in Sudden Sensorineural Hearing Loss. Time to Talk

G Conte, F Di Berardino, C Sina, D Zanetti, E Scola, C Gavagna, L Gaini, G Palumbo, P Capaccio, F Triulzi, G Conte, F Di Berardino, C Sina, D Zanetti, E Scola, C Gavagna, L Gaini, G Palumbo, P Capaccio, F Triulzi

Abstract

Sudden sensorineural hearing loss is defined as acute hearing loss of the sensorineural type of at least 30 dB over 3 contiguous frequencies that occurs within a 72-hour period. Although many different causative factors have been proposed, sudden sensorineural hearing loss is still considered "idiopathic" in 71%-85% of cases, and treatments are empiric, not based on etiology. MR imaging implemented with a 3D FLAIR sequence has provided new insights into the etiology of sudden sensorineural hearing loss. Herein, we review the current management trends for patients with sudden sensorineural hearing loss, from the initial clinical diagnosis to therapeutic strategies and diagnostic work-up. We focused primarily on MR imaging assessment and discuss the relevance that MR imaging findings might have for patient management, pointing out different perspectives for future clinical research.

© 2017 by American Journal of Neuroradiology.

Figures

Fig 1.
Fig 1.
Vascular pattern in a 20-year-old woman with left SSHL. Precontrast T1-weighted (A) and precontrast 3D-FLAIR (B) sequences show a high signal in the middle and upper turns of the left cochlea without enhancement on postcontrast T1-weighted (C) and 3D-FLAIR images (D).
Fig 2.
Fig 2.
Inflammatory pattern in a 35-year-old man with right SSHL. The precontrast T1-weighted sequence (A) shows no signal abnormalities. The precontrast 3D-FLAIR sequence (B) shows a high signal in the right cranial nerves VII and VIII and in the middle and upper turns of the left cochlea. A postcontrast T1-weighted sequence (C) does not show enhancement, whereas a postcontrast 3D-FLAIR sequence (D) shows the cochlea and cranial nerves VII and VIII as markedly enhanced on the right side.
Fig 3.
Fig 3.
Normal MR imaging findings in a 59-year-old man with right SSHL. The precontrast T1-weighted sequence (A) shows spontaneous hyperintense intralabyrinthine fluid in both inner ear structures (arrows), which is symmetric and less evident on the same sequence after contrast injection (B). This hyperintensity is an artifact caused by the altered dynamic range when the fat signal is subtracted, but also reflects an alteration in the visual appearance of signal intensity as the ambient contrast is changed (checker-shadow illusion).

References

    1. Rauch SD. Clinical practice. Idiopathic sudden sensoneurinal hearing loss. N Eng J Med 2008;359:833–40 10.1056/NEJMcp0802129
    1. Byl FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94:647–61
    1. Lawrence R, Thevasagayam R. Controversies in the management of sudden sensorineural hearing loss: an evidence-based review. Clin Otolaryngol 2015;40:176–82 10.1111/coa.12363
    1. Kuhn M, Heman-Ackah SE, Shaikh JA, et al. . Sudden sensorineural hearing loss: a review of diagnosis, treatment, and prognosis. Trends Amplif 2011;15:91–105 10.1177/1084713811408349
    1. Chau JK, Lin JR, Atashband S, et al. . Systematic review of the evidence for the etiology of adult sudden sensorineural hearing loss. Laryngoscope 2010;120:1011–21 10.1002/lary.20873
    1. Schreiber BE, Agrup C, Haskard DO, et al. . Sudden sensorineural hearing loss. Lancet 2010;375:1203–11 10.1016/S0140-6736(09)62071-7
    1. Conlin AE, Parnes LS. Treatment of sudden sensorineural hearing loss: I. A systematic review. Arch Otolaryngol Head Neck Surg 2007;133:573–81 10.1001/archotol.133.6.573
    1. Stachler RJ, Chandrasekhar SS, Archer SM, et al. . Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146:S1–35 10.1177/0194599812436449
    1. Lee HY, Jung SY, Park MS, et al. . Feasibility of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging as a prognostic factor in patients with sudden hearing loss. Eur Arch Otorhinolaryngol 2012;269:1885–91 10.1007/s00405-011-1834-1
    1. Lee JI, Yoon RG, Lee JH, et al. . Prognostic value of labyrinthine 3D-FLAIR abnormalities in idiopathic sudden sensorineural hearing loss. AJNR Am J Neuroradiol 2016;37:2317–22 10.3174/ajnr.A4901
    1. Yoshida T, Sugiura M, Naganawa S, et al. . Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging findings and prognosis in sudden sensorineural hearing loss. Laryngoscope 2008;118:1433–37 10.1097/MLG.0b013e318172ef85
    1. Ryu IS, Yoon TH, Ahn JH, et al. . Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging in sudden sensorineural hearing loss: correlations with audiologic and vestibular testing. Otol Neurotol 2011;32:1205–09 10.1097/MAO.0b013e31822e969f
    1. Kim TY, Park DW, Lee YJ, et al. . Comparison of inner ear contrast enhancement among patients with unilateral inner ear symptoms in MR images obtained 10 minutes and 4 hours after gadolinium injection. AJNR Am J Neuroradiol 2015;36:2367–72 10.3174/ajnr.A4439
    1. Berrettini S, Seccia V, Fortunato S, et al. . Analysis of the 3-dimensional fluid-attenuated inversion-recovery (3D-FLAIR) sequence in idiopathic sudden sensorineural hearing loss. JAMA Otolaryngol Head Neck Surg 2013;139:456–64 10.1001/jamaoto.2013.2659
    1. Zhu H, Ou Y, Fu J, et al. . A comparison of inner ear imaging features at different time points of sudden sensorineural hearing loss with three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging. Eur Arch Otorhinolaryngol 2015;272:2659–65 10.1007/s00405-014-3187-z
    1. Witsell DL, Khoury T, Schulz KA, et al. . Evaluation of compliance for treatment of sudden hearing loss: a CHEER Network study. Otolaryngol Head Neck Surg 2016;155:48–55 10.1177/0194599816650175
    1. Coelho DH, Thacker LR, Hsu DW. Variability in the management of idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2011;145:813–17 10.1177/0194599811412721
    1. Portmann M, Dauman R, Duriez F, et al. . Modern diagnostic strategy for acoustic neuromas. Arch Otorhinolaryngol 1989;246:286–91 10.1007/BF00463577
    1. Biavati MJ, Gross JD, Wilson WR, et al. . Magnetic resonance imaging evidence of a focal pontine ischemia in sudden hearing loss and seventh nerve paralysis. Am J Otol 1994;15:250–53 10.1016/0196-0709(94)90091-4
    1. Franklin DJ, Coker NJ, Jenkins HA. Sudden sensorineural hearing loss as a presentation of multiple sclerosis. Arch Otolaryngol Head Neck Surg 1989;115:41–45 10.1001/archotol.1989.01860250043023
    1. Hagiwara M, Roland JT Jr, Wu X, et al. . Identification of endolymphatic hydrops in Ménière's disease utilizing delayed postcontrast 3D FLAIR and fused 3D FLAIR and CISS color maps. Otol Neurotol 2014;35:e337–42 10.1097/MAO.0000000000000585
    1. Ryan M, Weissman JL, Kaylie D. Is Gadolinium contrast enhancement necessary in screening MRI for asymmetric sensorineural hearing loss? Laryngoscope 2015;125:783–84 10.1002/lary.24871
    1. Liao WH, Wu HM, Wu HY, et al. . Revisiting the relationship of three-dimensional fluid attenuation inversion recovery imaging and hearing outcomes in adults with idiopathic unilateral sudden sensorineural hearing loss. Eur J Radiol 2016;85:2188–94 10.1016/j.ejrad.2016.10.005
    1. Yagi A, Sato N, Takahashi A, et al. . Added value of contrast-enhanced CISS imaging in relation to conventional MR images for the evaluation of intracavernous cranial nerve lesions. Neuroradiology 2010;52:1101–09 10.1007/s00234-010-0690-9
    1. Huynh TN, Johnson T, Poder L, et al. . T1 pseudohyperintensity on fat-suppressed magnetic resonance imaging: a potential diagnostic pitfall. J Comput Assist Tomogr 2011;35:459–61 10.1097/RCT.0b013e31822227c3
    1. Mark AS, Fitzgerald D. Segmental enhancement of the cochlea on contrast-enhanced MR: correlation with the frequency of hearing loss and possible sign of perilymphatic fistula and autoimmune labyrinthitis. AJNR Am J Neuroradiol 1993;14:991–96
    1. Fitzgerald DC, Mark AS. Sudden hearing loss: frequency of abnormal findings on contrast-enhanced MR studies. AJNR Am J Neuroradiol 1998;19:1433–36
    1. Lee JW, Park YA, Park SM, et al. . Clinical features and prognosis of sudden sensorineural hearing loss secondary to intralabyrinthine hemorrhage. J Audiol Otol 2016;20:31–35 10.7874/jao.2016.20.1.31
    1. Ramos HV, Barros FA, Yamashita H, et al. . Magnetic resonance imaging in sudden deafness. Braz J Otorhinolaryngol 2005;71:422–26 10.1016/S1808-8694(15)31193-9
    1. Gao Z, Chi FL. The clinical value of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging in patients with idiopathic sudden sensorineural hearing loss: a meta-analysis. Otol Neurotol 2014;35:1730–35 10.1097/MAO.0000000000000611
    1. Conlin AE, Parnes LS. Treatment of sudden sensorineural hearing loss: II. A meta-analysis. Arch Otolaryngol Head Neck Surg 2007;133:582–86 10.1001/archotol.133.6.582
    1. Passamonti SM, Di Berardino F, Bucciarelli P, et al. . Risk factors for idiopathic sudden sensorineural hearing loss and their association with clinical outcome. Thromb Res 2015;135:508–12 10.1016/j.thromres.2015.01.001
    1. Capaccio P, Ottaviani F, Cuccarini V, et al. . Genetic and acquired prothrombotic risk factors and sudden hearing loss. Laryngoscope 2007;117:547–51 10.1097/MLG.0b013e31802f3c6a
    1. Quaranta N, De Ceglie V, D'Elia A. Endothelial dysfunction in idiopathic sudden sensorineural hearing loss: a review. Audiol Res 2016;6:151 10.4081/audiores.2016.151
    1. Moskowitz D, Lee KJ, Smith HW. Steroid use in idiopathic sudden sensorineural hearing loss. Laryngoscope 1984;94:664–66
    1. Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 1980;106:772–76 10.1001/archotol.1980.00790360050013
    1. Crane RA, Camilon M, Nguyen S, et al. . Steroids for treatment of sudden sensorineural hearing loss: a meta-analysis of randomized controlled trials. Laryngoscope 2015;125:209–17 10.1002/lary.24834
    1. Lavigne P, Lavigne F, Saliba I. Intratympanic corticosteroids injections: a systematic review of literature. Eur Arch Otorhinolaryngol 2016;273:2271–78 10.1007/s00405-015-3689-3
    1. Fattori B, Berrettini S, Casani A, et al. . Sudden hypoacusis treated with hyperbaric oxygen therapy: a controlled study. Ear Nose Throat J 2001;80:655–60
    1. Narozny W, Sicko Z, Przewozny T, et al. . Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment. Otol Neurotol 2004;25:916–23. 10.1097/00129492-200411000-00010
    1. Awad Z, Huins C, Pothier DD. Antivirals for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2012;8:CD006987 10.1002/14651858.CD006987.pub2

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