Inner Ear Test Battery Aligned with Hydrops Magnetic Resonance Imaging to Differentiate Acute-Onset Sensorineural...

Area of Science:

• Otolaryngology
• Neuroscience
• Diagnostic Imaging

Background:

• Acute-onset sensorineural hearing loss (SNHL) presents diagnostic challenges when not meeting criteria for sudden SNHL or Meniere's disease.
• Differentiating these ambiguous SNHL cases is crucial for appropriate management.

Purpose of the Study:

• To differentiate ambiguous cases of acute-onset SNHL.
• To investigate the utility of an inner ear test battery combined with Hydrops MRI.
• To explore the role of endolymphatic hydrops (EH) in these cases.

Main Methods:

• 46 patients with acute-onset SNHL underwent an inner ear test battery and Hydrops MRI.
• Patients were divided into endolymphatic hydrops (EH) positive (n=24) and negative (n=22) groups based on MRI findings.
• Hearing levels and vestibular test results were compared between groups.

Main Results:

• Significant hearing differences between EH and non-EH groups were noted at lower frequencies (125-1000 Hz).
• The EH group showed a declining pattern of abnormalities across audiometry, cVEMP, oVEMP, and caloric tests.
• EH prevalence on MRI decreased from cochlea (79%) to semicircular canals (4%), mirroring test abnormality rates.

Conclusions:

• Combining inner ear tests with Hydrops MRI aids in understanding SNHL disease mechanisms.
• This integrated approach can improve differential diagnosis for ambiguous acute-onset SNHL cases.
• The findings highlight the potential role of EH in specific SNHL presentations.