Lesion-specific prognosis by magnetic resonance imaging in sudden sensorineural hearing loss

[1] Gao Z, Chi FL. The clinical value of three-dimensional fluid-attenuated inversion

recovery magnetic resonance imaging in patients with idiopathic sudden

sensorineural hearing loss: a meta-analysis. Otol Neurotol. 2014;35(10):17301735.

[2] Kuhn M, Heman-Ackah SE, Shaikh JA, et al. Sudden sensorineural hearing loss: a

review of diagnosis, treatment, and prognosis. Trends Amplif. 2011;15(3):91–

105.

[3] Conte G, Di Berardino F, Sina C, et al. MR imaging in sudden sensorineural hearing

loss. Time to talk. AJNR Am J Neuroradiol. 2017;38(8):1475-1479.

[4] Lee JI, Yoon RG, Lee JH, et al. Prognostic value of labyrinthine 3D-FLAIR

abnormalities in idiopathic sudden sensorineural hearing loss. AJNR Am J

Neuroradiol. 2016;37(12):2317–2322.

[5] Berrettini S, Seccia V, Fortunato S, et al. Analysis of the 3-dimensional fluidattenuated inversion-recovery (3D-FLAIR) sequence in idiopathic sudden

sensorineural hearing loss. JAMA Otolaryngol Head Neck Surg.

2013;139(5):456-464.

[6] Yoshida T, Sugiura M, Naganawa S, et al. Three-dimensional fluid-attenuated

inversion recovery magnetic resonance imaging findings and prognosis in

sudden sensorineural hearing loss. Laryngoscope. 2008;118(8):1433-1437.

[7] Mizutari K. Spontaneous recovery of cochlear fibrocytes after severe degeneration

caused by acute energy failure. Front Pharmacol. 2014;5:198.

[8] Sugiura M, Naganawa S, Teranishi M, et al. Three-dimensional fluid-attenuated

inversion recovery magnetic resonance imaging findings in patients with sudden

sensorineural hearing loss. Laryngoscope. 2006;116(8):1451–1454.

[9] MacArthur C, Hausman F, Kempton B, et al. Intratympanic steroid treatments may

improve hearing via ion homeostasis alterations and not immune suppression.

Otol Neurotol. 2015;36(6):1089-1095.

[10] Naganawa S, Kawai H, Taoka T, et al. Heavily T2-weighted 3D-FLAIR improves

the detection of cochlear lymph fluid signal abnormalities in patients with

sudden sensorineural hearing loss. Magn Reson Med Sci. 2016;15(2):203-211.

[11] Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of

idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol.

1980;106(12):772-776.

[12] Nakashima T, Sato H, Gyo K, et al. Idiopathic sudden sensorineural hearing loss in

Japan. Acta Otolaryngol. 2014;134(11):1158-1163.

[13] Siegel LG. The treatment of idiopathic sudden sensorineural hearing loss.

Otolaryngol Clin North Am. 1975;8(2):467-473.

[14] Wilkins SA Jr, Mattox DE, Lyles A. Evaluation of a “shotgun” regimen for sudden

hearing loss. Otolaryngol Head Neck Surg. 1987;97(5):474-480.

[15] Wu R, Hoshino T. Changes in off-lesion endocochlear potential following

localized lesion in the lateral wall. Acta Otolaryngol. 1999;119(5):550–554.

[16] Wu R, Hoshino T. Long-term changes in off-lesion endocochlear potential after

induction of localized lesions in the lateral wall. Ann Otol Rhinol Laryngol.

2001;110(3):271-276.

[17] Kitao K, Mizutari K, Nakagawa S, et al. Recovery of endocochlear potential after

severe damage to lateral wall fibrocytes following acute cochlear energy failure.

Neuroreport. 2016;27(15):1159–1166.

[18] Psillas G, Rizou A, Rachovitsas D, et al. Hearing outcome of low-tone compared to

high-tone sudden sensorineural hearing loss. Int Arch Otorhinolaryngol.

2019;23(1):65-69.

Table 1. Characteristics of Patients with Idiopathic Sudden Sensorineural Hearing Loss

Figure 1. Example images to calculate the region of interest on hT2W-3D-FLAIR. We

draw the shape of each basal turn (A1) and apical-middle turn (B1) of the cochlea for

the region of interest on the SPACE sequence, then copy both shapes (A2) (B2) to draw

the region of interest on hT2W-3D-FLAIR, using the signal value of the cerebellar

hemisphere in the drawn circle (C) as a control. The image was obtained from a case

with grade 3 right ear hearing loss. hT2W-3D-FLAIR = heavily T2-weighted threedimensional fluid-attenuated inversion recovery; SPACE = sampling perfection with

application-optimized contrasts using different flip angle evolutions.

Figure 2. Comparison of SIRs between ears with better and worse hearing recoveries in

the grade 3-4 group. Pre-contrast SIRs of the basal turns in the group with worse

hearing recovery at high-tone frequencies are significantly higher than in those with

better hearing recovery. Post-contrast SIRs of the apical-middle turn in the group with

worse hearing recovery at low-tone frequencies are significantly higher than in those

with better hearing recovery. SIRs = signal intensity ratios.

TABLE 1. Characteristics of Patients with Idiopathic Sudden Sensorineural Hearing Loss

Grades 1-2

Grades 3-4

Characteristic

P Value

n= 10 (±SD)

n= 19 (±SD)

Sex (female / male)

3/7

4 / 15

NS

Affected ear (right / left)

4/6

4 / 15

NS

Initial HL at high-tone frequencies (dB)

49.2 (±16.5)

83.9 (±14.7)

< .001**

Initial HL at low-tone frequencies (dB)

52.0 (±16.3)

75.0 (±13.9)

.004**

Final HL at high-tone frequencies (dB)

31.0 (±25.2)

54.0 (±19.2)

.024*

Final HL at low-tone frequencies (dB)

18.5 (±10.4)

36.2 (±24.1)

.031*

Duration from onset to initial treatment (days)

1.9 (±0.8)

2.2 (±1.5)

NS

Duration from onset to MRI (days)

5.8 (±2.6)

7.8 (±3.9)

NS

HL = hearing level; SD = standard deviation; MRI = magnetic resonance imaging; NS = non-significant; *p<0.05

**p<0.01

...