Magnetic resonance imaging findings in sudden sensorineural hearing loss.
OBJECTIVE
To investigate the role of magnetic resonance imaging (MRI) in the diagnosis of sudden sensorineural hearing loss (SSNHL).


METHODS
Fifty-four consecutive patients affected by SSNHL were investigated using brain MRI. MRI was performed with an eight-channel phased-array head coil to study the entire audiovestibular pathway and the whole brain. The protocol study consisted of a high-resolution study of the temporal bone, internal auditory canal (IAC), cerebellopontine angle (CPA), and brainstem combining 2 mm thin-slice axial T(2)-weighted two-dimensional fast spin echo (FSE) and fluid-attenuated inversion recovery (FLAIR) sequences, pre- and postcontrast (gadolinium-diethylenetriamine pentaacetic acid) administration fat-suppressed axial T(1)-weighted two-dimensional FSE sequences, and a T(2)*-weighted three-dimensional Fourier transformation-constructive interference in steady state sequence (FT-CISS) , with 0.4 mm ultrathin partitions. The rest of the brain was studied with a 4 mm axial T(2)-weighted FLAIR sequence.


RESULTS
Thirty-one of 54 (57%) cases of SSNHL presented with MRI abnormalities. In 6 of 54 cases, the detected abnormality was directly correlated to the clinical picture (2 labyrinthine hemorrhage, 1 cochlear inflammation, 1 acoustic neuroma, 1 arachnoid cyst of the CPA, and 1 case of white matter lesions in the pons, compatible with demyelinating plaques along the central audiovestibular nervous pathway, as the first expression of multiple sclerosis).


CONCLUSIONS
An extensive MRI study of the audiovestibular nervous pathway and of the whole brain, pre- and postparamagnetic contrast administration, is recommended to rule out the wide spectrum of abnormalities that can cause SSNHL.
Cadoni
Gabriella
G
Department of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome, Italy. Gabcad@Tiscali.It
Cianfoni
Alessandro
A
Agostino
Stefania
S
Scipione
Simona
S
Tartaglione
Tommaso
T
Galli
Jacopo
J
Colosimo
Cesare
C
D000328:Adult; D000368:Aged; D016080:Arachnoid Cysts / Q000473:pathology; D001301:Audiometry, Pure-Tone; D001921:Brain / Q000473:pathology; D002531:Cerebellum / Q000098:blood supply; D003051:Cochlea / Q000473:pathology; D005260:Female; D005682:Gadolinium; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000473:pathology; D003639:Hearing Loss, Sudden / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology; D009464:Neuroma, Acoustic / Q000473:pathology
D005682:Gadolinium