The impact of labyrinthine magnetic resonance signal alterations on the treatment of sudden sensory-neural hearing loss

Abstract

Background

Sudden sensory-neural hearing loss (SSNHL), with positive findings on magnetic resonance imaging (MRI), possibly related to labyrinthine hemorrhage, is a rare condition and difficult to be diagnosed.

Objectives

We evaluated the role of MRI in detecting labyrinthine signal changes and the impact of these changes on the prognosis of SSNHL after the intratympanic corticosteroid injection.

Methods

A prospective study was held between January and June 2022. We included patients who complained of SSNHL, either idiopathic (30 patients) or labyrinthine signal alterations (14 patients), as diagnosed by MRI performed 15 days after the SSNHL onset. In addition, all patients underwent a course of intratympanic prednisolone injections.

Results

83.3% of the idiopathic group showed a complete or marked improvement after the intratympanic injection. Conversely, most cases of positive MR signal alterations (92.8%) had slight or poor improvement after the therapeutic course.

Conclusions

Our study revealed that MRI imaging is essential for assessing any SSNHL case. It can diagnose labyrinthine hemorrhage, whose course and prognosis differ significantly from idiopathic SSNHL.

Significance

Intratympanic prednisolone injection was effective in managing idiopathic SSNHL. On the other hand, this therapeutic modality was ineffective in improving SSNHL associated with labyrinthine hemorrhage.

Chinese Abstract

背景：突发性感觉神经性听力损失 (ssNhl) 具有磁共振成像 (MRI)阳性发现, 可能与迷路出血有关, 是一种罕见病症, 难以诊断。

目的：我们评估了 MRi 对于检测迷路信号变化的作用, 以及这些变化对鼓室内皮质类固醇注射后 ssNhl 预后的影响。

方法：在 2022 年 1 月至 2022 年 6 月期间进行了一项前瞻性研究。我们纳入了主诉 ssNhl 的患者。这些患者在 ssNhl 发作后 15 天经MRi 诊断为特发性（30 名患者）或迷路信号改变（14 名患者）。 此外, 所有患者均接受了一个疗程的鼓室内泼尼松龙注射。

结果：特发性组中83.3% 的患者在鼓室内注射后表现出完全或显著改善。 相反, 大多数阳性 MR 信号改变的病例 (92.8%) 在治疗过程后有轻微或较差的改善。

结论：我们的研究表明 MRI 成像对于评估任何 ssNhl 病例都是必不可少的。 它可以诊断迷路出血, 其病程和预后与特发性 ssNhl 有着显著差异。

意义：鼓室内注射泼尼松龙可有效治疗特发性 ssNhl。 而另一方面, 这种治疗方式在改善与迷路出血相关的 ssNhl 方面无效。

Keywords:

• Sudden sensory-neural hearing loss
• magnetic resonance imaging
• intratympanic injection
• prednisolone
• labyrinthine hemorrhage
• prognosis

Author contributions

E.C.: Designed the work; C.F.: Acquired and analyzed data; H.H.E.: Acquired and analyzed data; L.V.: Acquired and analyzed data; V.M.: Acquired and analyzed data; G.M.: Drafted, revised, and approved the manuscript; S.P.: Drafted, revised, approved the manuscript; A.R.: Drafted, revised, approved the manuscript; A.B.: Drafted, revised, approved the manuscript; M.B.: Agreed to be accountable for all aspects of the work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The authors have no budget or financial relationships to disclose.