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Incidental Findings on MRIs for Asymmetric Sensorineural Hearing Loss: A Clinical and Economic Analysis

  • 0Department of Otolaryngology-Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology +

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October 23, 2024

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October 23, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Incidentalomas found during MRI for asymmetric sensorineural hearing loss (ASNHL) are more common than the condition itself. These unexpected findings incur significant costs for patients and healthcare systems.

Area Of Science

  • Radiology
  • Otolaryngology
  • Health Economics

Background

  • Contrast-enhanced MRI is the gold standard for diagnosing asymmetric sensorineural hearing loss (ASNHL).
  • While vestibular schwannoma detection rates are low (<5%), MRI is considered cost-effective for ASNHL assessment.
  • The impact of incidentalomas, or unexpected findings, during ASNHL workup is often overlooked.

Purpose Of The Study

  • To determine the incidence of incidentalomas during the workup of ASNHL.
  • To quantify the socioeconomic burden associated with incidentalomas found in ASNHL investigations.

Main Methods

  • A retrospective cohort study was conducted at a single academic institution.
  • Radiology records of patients undergoing MRI for ASNHL between January 2012 and November 2022 were reviewed.
  • Findings were categorized, and costs for further workup of incidental findings were estimated using Medicare, private insurance, and uninsured cost data.

Main Results

  • Of 600 patients, 6.7% (40) had findings requiring further follow-up (group 4).
  • Incidentalomas occurred more than twice as often as retrocochlear pathologies causing ASNHL.
  • Estimated per-patient costs for incidentaloma workup were $744 (Medicare), $1,534 (private insurance), and $2,260 (uninsured).

Conclusions

  • Incidentalomas are frequently discovered during ASNHL MRI workups, exceeding the rate of identified retrocochlear pathologies.
  • While few patients require treatment for incidentalomas, their socioeconomic impact is considerable.
  • Healthcare payers and patients should account for the economic burden of incidentalomas in ASNHL diagnostic pathways.