Findings of Intravenous Gadolinium Inner Ear Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss
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Objectives. Acute low-tone sensorineural hearing loss (ALHL) is thought to have a different etiology from that of idiopathicsudden sensorineural hearing loss. We hypothesized that endolymphatic hydrops (EH) in the inner ear organ contrib-utes to ALHL, even in patients without vertigo. This study investigated the presence of EH in ALHL and compared theclinical characteristics of patients with or without EH. Methods. We retrospectively reviewed 38 patients diagnosed with ALHL without vertigo from January 2017 to March 2022. EH was measured in all patients using inner ear magnetic resonance imaging (MRI). In addition, we selected patientswho showed only mid- or high-frequency hearing loss and had available MRI data as a control group and comparedthe ALHL and control groups. Results. After treatment, the pure-tone average at low frequencies significantly improved compared to the initial hearing(P <0.001). Hearing recovery was observed in 63.1% of patients; however, the recovery rate did not differ based onthe treatment method. During the follow-up period, six patients (15.8%) progressed to Meniere’s disease, and 18(47.4%) experienced recurrence. In the ALHL group, the cochlear hydrops ratio on the affected side (0.34±0.09) wassignificantly higher than on the contralateral side (0.29±0.12) (P =0.005), and most patients showed hydrops in theapex area of the cochlea. Compared with the control group (0.25±0.15), the ALHL group showed a significantly highercochlear hydrops ratio (P =0.043). The correlation analysis showed a tendency for hearing thresholds at low frequen-cies to increase as the hydrops ratio increased, albeit without statistical significance. Conclusion. The cochlear hydrops ratio, especially in the apex area on the affected side, was significantly higher in patientswith ALHL, suggesting that EH in the cochlea contributes to the pathogenesis of ALHL.
Abstract
Objectives. Acute low-tone sensorineural hearing loss (ALHL) is thought to have a different etiology from that of idiopathicsudden sensorineural hearing loss. We hypothesized that endolymphatic hydrops (EH) in the inner ear organ contrib-utes to ALHL, even in patients without vertigo. This study investigated the presence of EH in ALHL and compared theclinical characteristics of patients with or without EH. Methods. We retrospectively reviewed 38 patients diagnosed with ALHL without vertigo from January 2017 to March 2022. EH was measured in all patients using inner ear magnetic resonance imaging (MRI). In addition, we selected patientswho showed only mid- or high-frequency hearing loss and had available MRI data as a control group and comparedthe ALHL and control groups. Results. After treatment, the pure-tone average at low frequencies significantly improved compared to the initial hearing(P <0.001). Hearing recovery was observed in 63.1% of patients; however, the recovery rate did not differ based onthe treatment method. During the follow-up period, six patients (15.8%) progressed to Meniere’s disease, and 18(47.4%) experienced recurrence. In the ALHL group, the cochlear hydrops ratio on the affected side (0.34±0.09) wassignificantly higher than on the contralateral side (0.29±0.12) (P =0.005), and most patients showed hydrops in theapex area of the cochlea. Compared with the control group (0.25±0.15), the ALHL group showed a significantly highercochlear hydrops ratio (P =0.043). The correlation analysis showed a tendency for hearing thresholds at low frequen-cies to increase as the hydrops ratio increased, albeit without statistical significance. Conclusion. The cochlear hydrops ratio, especially in the apex area on the affected side, was significantly higher in patientswith ALHL, suggesting that EH in the cochlea contributes to the pathogenesis of ALHL.
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