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Kim M, Lee HJ, Lee S, Lee J, Kang Y. Three-dimensional heavily T2-weighted FLAIR in the detection of blood-labyrinthine barrier leakage in patients with sudden sensorineural hearing loss: comparison with T1 sequences and application of deep learning-based reconstruction. Eur Radiol 2024; 34:5379-5388. [PMID: 38231393 DOI: 10.1007/s00330-023-10580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Blood-labyrinthine barrier leakage has been reported in sudden sensorineural hearing loss (SSNHL). We compared immediate post-contrast 3D heavily T2-weighted fluid-attenuated inversion recovery (FLAIR), T1 spin echo (SE), and 3D T1 gradient echo (GRE) sequences, and heavily T2-weighted FLAIR (hvT2F) with and without deep learning-based reconstruction (DLR) in detecting perilymphatic enhancement. METHODS Fifty-four patients with unilateral SSNHL who underwent ear MRI with three sequences were included. We compared asymmetry scores, confidence scores, and detection rates of perilymphatic enhancement among the three sequences and obtained 3D hvT2F with DLR from 35 patients. The above parameters and subjective image quality between 3D hvT2F with and without DLR were compared. RESULTS Asymmetry scores and detection rate of 3D hvT2F were significantly higher than 3D GRE T1 and SE T1 (respectively, 1.37, 0.11, 0.19; p < 0.001). Asymmetry scores significantly increased with DLR compared to 3D hvT2F for experienced and inexperienced readers (respectively, 1.77 vs. 1.40, p = 0.036; 1.49 vs. 1.03, p = 0.012). The detection rate significantly increased only for the latter (57.1% vs. 31.4%, p = 0.022). Patients with perilymphatic enhancement had significantly higher air conduction thresholds on initial (77.96 vs. 57.79, p = 0.002) and 5 days after presentation (63.38 vs. 41.85, p = 0.019). CONCLUSION 3D hvT2F significantly increased the detectability of perilymphatic enhancement compared to 3D GRE T1 and SE T1. DLR further improved the conspicuity of perilymphatic enhancement in 3D hvT2F. 3D hvT2F and DLR are useful for evaluating blood-labyrinthine barrier leakage; furthermore, they might provide prognostic value in the early post-treatment period. CLINICAL RELEVANCE STATEMENT Ten-minute post-contrast 3D heavily T2-weighed FLAIR imaging is a potentially efficacious sequence in demonstrating perilymphatic enhancement in patients with sudden sensorineural hearing loss and may be further improved by deep learning-based reconstruction. KEY POINTS • 3D heavily T2-weighted FLAIR (3D hvT2F) is a sequence sensitive in detecting low concentrations of contrast in the perilymphatic space. • 3D hvT2F sequences properly demonstrated perilymphatic enhancement in sudden sensorineural hearing loss compared to T1 sequences and were further improved by deep learning-based reconstruction (DLR). • 3D hvT2F and DLR are efficacious sequences in detecting blood-labyrinthine barrier leakage and with potential prognostic information.
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Affiliation(s)
- Mingyu Kim
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Seokhwan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | | | - Yeonah Kang
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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Zhang Z, Yu C, Wang X, Ge S, Zhai G, Si S, Ma T, Li F, Cui Z, Jin X, Jin Y. The construction and validation of prognostic prediction model for sudden sensorineural hearing loss in middle-aged and elderly people. Auris Nasus Larynx 2024; 51:276-285. [PMID: 37872076 DOI: 10.1016/j.anl.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Idiopathic sudden sensorineural hearing loss (ISSNHL), as an otologic emergency, is commonly encountered and its prevalence has been climbing every year recently. To our knowledge, the prognosis of middle-aged and elderly patients is worse than that of young patients. Previous researches mainly focused on the adult population, which was considered as prognostic models who performed hearing recovery in ISSNHL. However, few studies regarding the middle-aged and elderly population who are regarded as prognostic models have been reported. Therefore, we aim to construct and validate a nomogram-based prognostic prediction model, which can provide a reference for the prognostic assessment in the middle-aged and elderly patients with ISSNHL. METHOD A total of 371 middle-aged and elderly ISSNHL patients who were admitted to the Department of Otolaryngology-Head and Neck Surgery, Yanbian Hospital, Yanbian University, from April 2018 to April 2023 were enrolled in the study. All subjects were randomly divided into two groups including training group (n = 263) and validation group (n = 108). Lasso regression and multi-factor logistic regression were jointly utilized to screen out prognosis-related independent risk factors and establish a nomogram-based risk prediction model. The accuracy and clinical application value of the model were evaluated by combining the Bootstrapping method and k-fold cross-validation, plotting the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUC), plotting the decision curve analysis (DCA), and the calibrating curve. RESULT We used the method of lasso regression combined with multivariate logistic regression and finally screened out eight predictors (including age, number of affected ears, degree of hearing loss, type of hearing curve, duration of disease, presence of vertigo, diabetes, and lacunar cerebral infarction) that were included into the nomogram. The C-index were 0.823 [95% CI (0.725, 0.921)] and 0.851 [95% CI (0.701, 1.000)], and the AUC values were 0.812 and 0.823 for the training and validation groups, respectively. The calibration curve for the validation group was approximately conformed to that for the modeling group, indicating favorable model calibration. The DCA results revealed the modeling group (3%-86%) and the validation group (2%-92%) showed significant net clinical benefit under the majority of thresholds. CONCLUSION This study developed and validated a nomogram-based prognostic prediction model which based on the eight independent risk factors mentioned above. The predictors are conveniently accessible and may assist clinicians in formulating individualized treatment strategies.
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Affiliation(s)
- Zhiqiang Zhang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Changxu Yu
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xueyan Wang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Sitong Ge
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Guanhong Zhai
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Shurui Si
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Tianyi Ma
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Fuyao Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Zhezhu Cui
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China
| | - Xianghua Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China.
| | - Yulian Jin
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Yanbian University, Yanji, China; Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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3
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Todic J, Guinand N, Lenoir V, Senn P, Becker M. Diagnostic value and prognostic significance of MRI findings in sudden sensorineural hearing loss. Laryngoscope Investig Otolaryngol 2022; 7:1575-1583. [PMID: 36258869 PMCID: PMC9575048 DOI: 10.1002/lio2.922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose We evaluated the clinical significance of magnetic resonance imaging (MRI) findings and their prognostic value for initial hearing loss and recovery in patients with sudden sensorineural hearing loss (SSNHL). Materials and Methods This retrospective study included consecutive adult patients with unilateral SSNHL, contrast-enhanced MRI and audiometric testing evaluated in our institution between 2005 and 2017. MRI reports, patient data, treatment, and audiometric tests were reviewed, with the relationship between MRI findings and hearing loss/recovery analyzed. Results Overall, 266 patients were included. Additional symptoms comprised tinnitus (114/266; 43%), vertigo (45/266; 17%), ear pain (26/266; 10%), and ear pressure (6/266; 2%). At least one cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, cardiopathy, and active smoking) existed in 167/266 (63%) patients. Corticosteroid treatment was followed by 198/266 (74%) patients while contraindications/refusal/compliance precluded treatment in 68/266(26%). Complete, partial or slight hearing recovery occurred in 167/266 (63%) patients. Three MRI patient groups were identified: a group with normal MRI examinations or incidentalomas (128/266; 48%), a group with peripheral auditory system (PAS) lesions (95/266; 36%), and a group with central nervous system (CNS) lesions (43/266; 16%). PAS lesions included lesions from the cochlea to the brain stem (e.g., schwannoma, meningioma, labyrinthitis, intracochlear hemorrhage, vestibulocochlear neuritis), whereas CNS lesions corresponded in 42/43(98%) of cases to leukoaraiosis and other vascular lesions (e.g., stroke, hemorrhage, aneurysm, venous sinus thrombosis, and cavernoma). Belonging to one of the three MRI groups did not influence the degree of initial hearing loss, affected frequencies or treatment, p > .05. Gender and cardiovascular risk factors did neither affect initial hearing loss nor recovery. However, age > 70 years negatively affected initial hearing loss in all frequencies, as well as recovery in all frequencies except 1000 Hz. Also, poor recovery of initial high-frequency hearing loss (>1000 Hz) was significantly associated with CNS lesions. Conclusion Age > 70 years and CNS lesions depicted by MRI independently predicted poor auditory recovery, albeit in different frequencies. Lay Summary In patients with sudden hearing loss, older age (above 70 years) predicts poorer hearing recovery than in younger patients in most hearing frequencies. In addition, abnormalities of brain tissue revealed by MRI predict poorer hearing recovery at high frequencies. Level of Evidence Level III.
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Affiliation(s)
- Jelena Todic
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology Head and Neck Surgery, Geneva University HospitalsUniversity of GenevaGenevaSwitzerland
- Present address:
Department of Surgery, Clinic of Otorhinolaryngology Head and Neck Surgery, CHUVUniversity of LausanneLausanneSwitzerland
| | - Nils Guinand
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology Head and Neck Surgery, Geneva University HospitalsUniversity of GenevaGenevaSwitzerland
| | - Vincent Lenoir
- Diagnostic Department, Division of Radiology, Geneva University HospitalsUniversity of GenevaGenevaSwitzerland
| | - Pascal Senn
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology Head and Neck Surgery, Geneva University HospitalsUniversity of GenevaGenevaSwitzerland
| | - Minerva Becker
- Diagnostic Department, Division of Radiology, Geneva University HospitalsUniversity of GenevaGenevaSwitzerland
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Xiong W, Dai Q, Wang Y, Hou Z, Lu K, Sun X, Duan F, Wang H, Zhang D, Wang M. Idiopathic Sudden Sensorineural Hearing Loss in Different Ages: Prognosis of Patients With Initial Total Hearing Loss. Front Psychol 2022; 13:818967. [PMID: 35401359 PMCID: PMC8987369 DOI: 10.3389/fpsyg.2022.818967] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/11/2022] [Indexed: 11/28/2022] Open
Abstract
Objective This study aimed to analyze the hearing improvement and prognosis factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in different ages with initial total hearing loss. Methods We reviewed the medical records of 5,711 hospitalized patients with ISSNHL from 2016 to 2021 in our center. All of the patients had been treated with uniform combination drug therapy. After excluding the patients with initial partial hearing loss and those diagnosed with clear etiology, 188 patients were enrolled in this study and divided into six age groups (18–30, 31–40, 41–50, 51–60, 61–70, ≥ 71 years). In all groups, decreases in pure-tone average (PTA) 1 month posttreatment, effective rate, and clinical characteristics (vertigo, tinnitus, hospital stay, comorbidity, and inner ear magnetic resonance imaging) were analyzed. Results Among the 188 enrolled patients, 86% had vertigo. Complete recovery was seen in 0.5% of patients, and marked recovery was seen in 43% of patients. The mean 1 month posttreatment PTAs were as follows: 18–30 years: 80 ± 7.5 dB; 31–40 years: 100 ± 9.0 dB; 41–50 years: 99 ± 8.3 dB; 51–60 years: 101 ± 8.6 dB; 61–70 years: 96 ± 9.6 dB; and ≥ 71 years: 88 ± 13.0 dB. Compared with the other groups, the 18–30- years group showed better recovery of hearing threshold in five frequencies (0.25, 0.5, 1, 2, and 4 kHz, respectively, at octave or semioctave frequencies under air conduction), and the recovery of hearing threshold at 0.25 and 0.5 Hz was better than the recovery at 1, 2, and 4 kHz. According to the results of the chi-square test statistical analysis, vertigo and comorbidities were associated with a poor prognosis of ISSNHL. Conclusion In summary, the treatment outcomes of patients with ISSNHL with initial total hearing loss were poor. There was a significant age-related difference with respect to marked recovery 1 month posttreatment, and the 18–30- years group showed better recovery than the other age groups.
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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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Jeong M, Ocwieja KE, Han D, Wackym PA, Zhang Y, Brown A, Moncada C, Vambutas A, Kanne T, Crain R, Siegel N, Leger V, Santos F, Welling DB, Gehrke L, Stankovic KM. Direct SARS-CoV-2 infection of the human inner ear may underlie COVID-19-associated audiovestibular dysfunction. COMMUNICATIONS MEDICINE 2021; 1:44. [PMID: 34870285 PMCID: PMC8633908 DOI: 10.1038/s43856-021-00044-w] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND COVID-19 is a pandemic respiratory and vascular disease caused by SARS-CoV-2 virus. There is a growing number of sensory deficits associated with COVID-19 and molecular mechanisms underlying these deficits are incompletely understood. METHODS We report a series of ten COVID-19 patients with audiovestibular symptoms such as hearing loss, vestibular dysfunction and tinnitus. To investigate the causal relationship between SARS-CoV-2 and audiovestibular dysfunction, we examine human inner ear tissue, human inner ear in vitro cellular models, and mouse inner ear tissue. RESULTS We demonstrate that adult human inner ear tissue co-expresses the angiotensin-converting enzyme 2 (ACE2) receptor for SARS-CoV-2 virus, and the transmembrane protease serine 2 (TMPRSS2) and FURIN cofactors required for virus entry. Furthermore, hair cells and Schwann cells in explanted human vestibular tissue can be infected by SARS-CoV-2, as demonstrated by confocal microscopy. We establish three human induced pluripotent stem cell (hiPSC)-derived in vitro models of the inner ear for infection: two-dimensional otic prosensory cells (OPCs) and Schwann cell precursors (SCPs), and three-dimensional inner ear organoids. Both OPCs and SCPs express ACE2, TMPRSS2, and FURIN, with lower ACE2 and FURIN expression in SCPs. OPCs are permissive to SARS-CoV-2 infection; lower infection rates exist in isogenic SCPs. The inner ear organoids show that hair cells express ACE2 and are targets for SARS-CoV-2. CONCLUSIONS Our results provide mechanistic explanations of audiovestibular dysfunction in COVID-19 patients and introduce hiPSC-derived systems for studying infectious human otologic disease.
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Affiliation(s)
- Minjin Jeong
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
- Present Address: Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA USA
| | - Karen E. Ocwieja
- Department of Pediatrics, Harvard Medical School, Boston, MA USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA USA
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Boston, MA USA
| | - Dongjun Han
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
- Present Address: Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA USA
| | - P. Ashley Wackym
- Department of Otolaryngology—Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Yichen Zhang
- Harvard-MIT Program in Health Science and Technology, Boston, MA USA
| | - Alyssa Brown
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
| | - Cynthia Moncada
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
| | - Andrea Vambutas
- Department of Otolaryngology Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, New Hyde Park, NY USA
| | - Theodore Kanne
- ENT and Allergy Associates of South Georgia, Valdosta, GA USA
| | | | - Noah Siegel
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
| | - Valerie Leger
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Boston, MA USA
| | - Felipe Santos
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
| | - D. Bradley Welling
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
| | - Lee Gehrke
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Boston, MA USA
- Harvard-MIT Program in Health Science and Technology, Boston, MA USA
- Department of Microbiology, Harvard Medical School, Boston, MA USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology—Head and Neck Surgery, Harvard Medical School, Boston, MA USA
- Eaton Peabody Laboratories and Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA USA
- Present Address: Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA USA
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Qin H, He B, Wu H, Li Y, Chen J, Wang W, Zhang F, Duan M, Yang J. Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion. Front Surg 2021; 8:682245. [PMID: 34235173 PMCID: PMC8255360 DOI: 10.3389/fsurg.2021.682245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: The aim of this study is to evaluate the possible value of endolymphatic hydrops (EH) in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL) with four types according to audiometry. Methods: Seventy-two patients (40 men and 32 women; age range, 28–78 years; mean age: 50.0 ± 12.9 years) with UISSNHL were admitted retrospectively into this study. Based on the pure tone audiometry before treatment, the hearing loss of all these patients were categorized into four types: low-frequency group (LF-G), high-frequency group (HF-G), flat group (F-G), and total deafness group (TD-G). The average time from symptom onset to the first examination was 6.9 ± 4.4 days (1–20 days). 3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium (Gd) within 1 week after the UISSNHL onset. The incidence of EH in the affected ears based on four types of hearing loss were analyzed using the Chi-square test, and the possible relationship with vertigo and prognosis were also assessed. Results: Eleven of 21 patients (52.4%) in LF-G had the highest EH-positive rate, followed by 18.2% in HF-G, 11.8% in F-G, and 17.4% in TD-G. The significant difference was found in the four groups (P = 0.018). The EH rate of LF-G was statistically significantly higher than that of F-G and TD-G (P = 0.009, P =0.014), respectively. After being valued by the volume-referencing grading system (VR scores), the EH level was represented by the sum scores of EH. In LF-G, no statistically significant difference was found in the prognosis of ISSNHL patients between with the EH group and the no EH group (P = 0.586). The symptom “vertigo” did not correlate with EH and prognosis. Conclusions: EH was observed in UISSNHL patients by 3D-FLAIR MRI. EH may be responsible for the pathology of LF-G but not related to prognosis. It might be meaningless to assess EH in other hearing loss types, which might be more related to the blood-labyrinth dysfunction.
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Affiliation(s)
- Huan Qin
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Baihui He
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Hui Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yue Li
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jianyong Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Wei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Fan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Department of Otolaryngology Head and Neck, Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden.,Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Jun Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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