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Published on: February 21, 2018
Evaluation of pediatric sensorineural hearing loss with magnetic resonance imaging
John E McClay1, Timothy N Booth, David A Parry
1Department of Otolaryngology/Head and Neck Surgery, University of Texas at Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 73235-9035, USA. john.mcclay@utsouthwestern.edu
Insights
Magnetic resonance imaging (MRI) reveals that 40% of children with sensorineural hearing loss (SNHL) have inner ear abnormalities, most commonly affecting the cochlea and cochlear nerve. Severe SNHL and unilateral hearing loss correlate with higher abnormality rates.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Otolaryngology
Background:
- Sensorineural hearing loss (SNHL) is a common condition in children.
- Identifying the underlying causes of SNHL is crucial for appropriate management.
- Magnetic resonance imaging (MRI) is a key diagnostic tool for evaluating SNHL.
Purpose of the Study:
- To determine the incidence and types of intracranial and inner ear abnormalities in children with SNHL.
- To stratify these abnormalities based on the degree and type of SNHL.
- To correlate MRI findings with SNHL characteristics.
Main Methods:
- Retrospective review of medical records and MRI scans of 170 children (aged 1 month to 17 years) with SNHL.
- Analysis of intracranial contents, inner ear structures, and cochlear nerves.
- Stratification of findings by SNHL severity (mild, moderate, severe, profound) and laterality (unilateral, bilateral).
Main Results:
- Inner ear abnormalities were identified in 40% of evaluated ears.
- The most frequent abnormalities included cochlear anomalies (32%) and cochlear nerve deficits (18%).
- Severe/profound SNHL (48%) and unilateral SNHL (62% in moderate/severe/profound cases) showed higher rates of inner ear abnormalities compared to mild/moderate and bilateral SNHL, respectively.
Conclusions:
- Approximately 40% of pediatric SNHL cases exhibit inner ear abnormalities on MRI.
- Abnormalities of the cochlea and cochlear nerve are the most prevalent findings.
- Higher degrees of SNHL (severe/profound) and unilateral hearing loss are associated with increased incidence of inner ear anomalies.
Objective:
To evaluate the incidence and type of intracranial and inner ear abnormalities in children with sensorineural hearing loss (SNHL) identified with magnetic resonance imaging (MRI) and stratified by the degree and type of SNHL.
Design:
Retrospective review of medical records and MRIs.
Setting:
Tertiary care children's hospital.
Patients:
A total of 227 children aged 1 month to 17 years (mean age, 5.3 years; male to female ratio, 1:1) with a diagnosis of SNHL underwent MRI from June 1,1996, to June 1, 2002. Of these children, 170 had clinical information available and technically adequate MRIs and were included in the study.
Intervention:
Magnetic resonance imaging.
Main Outcome Measure:
Identification of an abnormality of the intracranial contents, inner ear, and cochlear nerve.
Results:
Of the 170 children, 101 (59%) had bilateral SNHL and 69 (41%) had unilateral SNHL, comprising 271 ears with SNHL. Abnormalities of the inner ear were found in 108 ears (40%) with 87 (32%) having abnormalities of the cochlea, which were considered mild in 63 (23%) and moderate to severe in 24 (9%). Forty-nine of 271 ears (18%) with SNHL demonstrated an either absent (26/49 [53%]) or deficient (23/49 [47%]) cochlear nerve. Ears with severe and profound SNHL had more abnormalities than ears with mild and moderate SNHL (66/138 [48%] vs 23/80 [29%]; P = .006), and children having ears with unilateral moderate, severe, or profound SNHL had more inner ear abnormalities than children with bilateral moderate, severe, or profound SNHL (28/45 [62%] vs 54/144 [38%]; P = .004).
Conclusions:
The overall incidence of inner ear abnormalities in ears of children with SNHL evaluated by MRI is 40%. The most common abnormalities seen were an abnormal cochlea and abnormal cochlear nerve. Children with severe and profound SNHL have a greater percentage of inner ear anomalies than children with mild or moderate SNHL. Children with unilateral hearing loss have a greater percentage of inner ear anomalies than children with bilateral SNHL.
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