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Sone M, Kobayashi M, Yoshida T, Naganawa S. Pathophysiological analysis of idiopathic sudden sensorineural hearing loss by magnetic resonance imaging: A mini scoping review. Front Neurol 2023; 14:1193104. [PMID: 37153681 PMCID: PMC10159174 DOI: 10.3389/fneur.2023.1193104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Objective To summarize the pathophysiological analysis of idiopathic sudden sensorineural hearing loss (ISSNHL) by magnetic resonance imaging (MRI), focusing on the findings of high signal or endolymphatic hydrops (EH) in the inner ear. Methods We summarize the published studies of our research group regarding the pathophysiological analysis of ISSNHL on MRI and review related clinical articles that have reported significantly high signal or the existence of EH in ears with ISSNHL. Results Pre-contrast high signal on MRI may indicate minor hemorrhage or increased permeability of surrounding vessels to the perilymph, whereas post-contrast high signal indicates breakdown of the blood-labyrinth barrier, in which irreversible changes would lead to poor prognosis. In some cases of ISSNHL, primary EH could be pre-existing and may be a risk factor for the onset of ISSNHL. Conclusion Analysis of ISSNHL by cutting-edge MRI evaluation could provide useful information for elucidating its pathophysiology and for predicting prognosis in this disease.
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Affiliation(s)
- Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- *Correspondence: Michihiko Sone,
| | - Masumi Kobayashi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Chen L, Wang Y, Gao X, Xiong W, Duan F, Zhang N, Wang H, Wang M. Thromboelastography Predicting the Prognosis of Sudden Sensorineural Hearing Loss. Clin Otolaryngol 2022; 47:724-731. [PMID: 35818895 DOI: 10.1111/coa.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/24/2022] [Accepted: 06/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore the association between thromboelastography and the clinical features as well as the prognosis of sudden sensorineural hearing loss (SSNHL). DESIGN Single-centre, retrospective study. SETTING A hospital in China PARTICIPANTS: In total, 133 patients presenting with SSNHL within 2 weeks before the study, who did not receive treatment. MAIN OUTCOME MEASURES The patients' medical history was collected. Audiological, imaging, and haematological examinations were performed before treatment. Patients with abnormal thromboelastography were re-examined 1 week after treatment, and efficacy was evaluated 1 month after treatment. The chi-squared test and binary logistic regression analysis were used to analyse the association between factors, such as vertigo, degree and type of hearing loss, vestibular function, inner ear MRI results, thromboelastography, and efficacy of treatment. RESULTS Thromboelastography was correlated with prognosis (P=0.049) and degree (P=0.030) and type of hearing loss (P=0.013) in patients with SSNHL. The R (P=0.002) and angle values (P=0.010) correlated with prognosis. The MA (P=0.022) and G values (P=0.020) correlated with the degree of hearing loss. The R (P=0.033) value correlated with inner ear MRI results, and the ΔG (P=0.010) value correlated with fibrinogen levels. ΔThromboelastography (P=0.032) was correlated with the prognosis of patients with abnormal thromboelastography results. Logistic regression analysis showed that thromboelastography correlated with prognosis (P=0.013), and Δthromboelastography correlated with the prognosis of patients with abnormal thromboelastography results (P=0.013) and vertigo (P=0.016). CONCLUSION Thromboelastography is an independent risk factor affecting the prognosis of SSNHL with the R and angle values playing a major role.
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Affiliation(s)
- Lei Chen
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Yingjun Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Xin Gao
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Wenping Xiong
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Fujia Duan
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
| | - Na Zhang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China
| | - Haibo Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China
| | - Mingming Wang
- Department of Otolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan250022, P.R. China.,Department of Otology Medicine, Shandong Provincial ENT Hospital, Jinan, China
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Compagnone L, Levigne V, Pereira B, Boyer L, Mom T, Mirafzal S. Injected 3T-3D-FLAIR-MRI labyrinthine patterns match with the severity and tonotopic alteration in sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2022; 279:4883-4891. [PMID: 35286438 DOI: 10.1007/s00405-022-07328-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the study was to assess a correlation between MRI labyrinthine changes detected with IV-gadolinium optimized high-resolution 3D-FLAIR sequences 4 h after injection (OPT4-3DFLAIR) and the type of SSNHL, in terms of frequency alteration and severity. METHODS This was a prospective monocentric study achieved from July 2019 to December 2020. The inclusion criterion was acute hearing loss of at least 30 dB over three contiguous frequencies occurring within a 72-h period, documented by a pure-tone audiometry (PTA). The primary endpoint was the visual assessment of hyperintensity in labyrinthine structures on OPT4-3DFLAIR performed on 3T MRI. RESULTS Thirty-six affected ears were included (20 men, 15 women; mean age: 54.5 ± 16.3 years) with 69.4% full-spectrum hearing loss. The median hearing loss, expressed as median and interquartile range [IQR] was 91 dB [74-120], with 47.2% of concomitant acute vestibular syndrome. Pathological signal was found in 26 out of 36 ears (72.2%). Basal turn enhancement was found in all abnormal MRIs, with 73.1% of apical turn enhancement and 50% of vestibular enhancement. Seventeen on 19 cases (89.5%) with apical involvement on MRI had low-frequency hearing loss. Vestibular involvement on MRI was significantly associated with a wider frequency range of hearing loss (p = 0.0002) and the severity of SSNHL (84.5 [71.7-92.5] dB versus 120 [85.8-120] dB, p = 0.0158). CONCLUSION This report shows that in pathological MRI in SSNHL, a pathologic cochlear base signal is always detected, a cochlear apical turn enhancement matches with low-tone impairment, and a pathological signal within the posterior labyrinth is associated with an impairment of all frequencies and the severity of SSNHL.
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Affiliation(s)
- L Compagnone
- Department of Otolaryngology Head Neck Surgery, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - V Levigne
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - B Pereira
- Department of Biostatistics, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - L Boyer
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - T Mom
- Department of Otolaryngology Head Neck Surgery, CHU Gabriel Montpied, Clermont-Ferrand, France. .,Unité Mixte de Recherche (UMR 1107) Institut National de La Recherche Scientifique Médicale (INSERM), Université Clermont Auvergne (UCA), Clermont-Ferrand, France.
| | - S Mirafzal
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France
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Wang M, Hu N, Wang Y, Sun X, Fan Z, Wang H. Clinical Value of 3D-FLAIR MRI in Idiopathic Sudden Sensorineural Hearing Loss. ACS Chem Neurosci 2022; 13:151-157. [PMID: 34918902 DOI: 10.1021/acschemneuro.1c00687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Three-dimensional fluid-attenuated inversion recovery sequence magnetic resonance imaging (3D-FLAIR MRI) has been used in the diagnosis of inner ear diseases. However, the relevance of 3D-FLAIR MRI appearances with multiple features and prognosis of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) remains unclear. METHODS This study was a retrospective trial. We recruited 1300 patients with unilateral ISSNHL hospitalized from May 2017 to January 2019. They were divided into four groups according to their 3D-FLAIR MRI appearances: normal (n = 739), inner ear hemorrhage (n = 218), increased protein content (n = 288), and blood-labyrinth barrier damage (n = 55). The correlation between 3D-FLAIR MRI appearances and the degree or type of deafness of the participants was analyzed. RESULTS There was a statistical difference in the deafness side (p < 0.001) and vestibular dysfunction (p < 0.001) among the four groups. There was a statistical difference in the duration of treatment (p < 0.001) and the incidence of dizziness or vertigo (p < 0.001) for patients among these groups. The degree of deafness in the patients in the inner ear hemorrhage group was significantly more severe than that of the patients in the other three groups (p < 0.001). CONCLUSION 3D-FLAIR MRI appearances were correlated with the prognosis of patients with ISSNHL.
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Affiliation(s)
- Mingming Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, 4# Duanxing West Road, Jinan 250022, China
| | - Na Hu
- Department of Radiology, Shandong Second Provincial General Hospital, 4# Duanxing West Road, Jinan 250022, China
| | - Yingjun Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, 4# Duanxing West Road, Jinan 250022, China
| | - Xiao Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, 4# Duanxing West Road, Jinan 250022, China
| | - Zhaomin Fan
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, 4# Duanxing West Road, Jinan 250022, China
| | - Haibo Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, 4# Duanxing West Road, Jinan 250022, China
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Sudden sensorineural hearing loss with vertigo as an initial presenting symptom of HIV/AIDS patient. AIDS 2021; 35:2553-2555. [PMID: 34870936 DOI: 10.1097/qad.0000000000003047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yoshida T, Kobayashi M, Sugimoto S, Teranishi M, Naganawa S, Sone M. Evaluation of the blood-perilymph barrier in ears with endolymphatic hydrops. Acta Otolaryngol 2021; 141:736-741. [PMID: 34346271 DOI: 10.1080/00016489.2021.1957500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Otological diseases including Meniere's disease (MD) involve endolymphatic hydrops (EH), which can be visualized by magnetic resonance imaging (MRI) with gadolinium contrast agents, but the temporal changes of contrast in the inner ear have not been evaluated. OBJECTIVES We investigated the permeability of the blood-perilymph barrier (BPB) in ears with EH to evaluate the severity of the inner ear disturbances. MATERIALS AND METHODS The study included 32 ears from 16 patients with EH or related diseases who underwent MRI. The permeability of the BPB was assessed by the signal-intensity ratio (SIR) at four-time points: before and at 10 min, 4 h, and 24 h after administration of gadolinium for assessing EH. RESULTS Cochlear EH was found in 25 of the 32 ears, and vestibular EH in 11. The rate of EH was significantly higher in symptomatic ears; however, the existence of EH was not related to SIR values. Nevertheless, SIR values in the basal turn were significantly higher 4 and 24 h after injection of gadolinium in patients aged ≥50 years. CONCLUSION AND SIGNIFICANCE Higher SIR values observed in older patients with EH indicate severe disturbances of the BPB in the cochlea, which may account for intractable inner ear disturbances in older patients.
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Affiliation(s)
- Tadao Yoshida
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masumi Kobayashi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satofumi Sugimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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