Feasibility of magnetic resonance imaging in the differential diagnosis of isolated acute audiovestibular loss

Abstract

BACKGROUND: Isolated acute audiovestibular loss is characterized by the sudden onset of unilateral hearing loss and prolonged vertigo. OBJECTIVE: The purpose of this study is aimed to identify the value of magnetic resonance imaging (MRI) for the evaluation of isolated acute audiovestibular loss. METHODS: We retrospectively enrolled 31 patients with isolated acute audiovestibular loss from March 2007 to December 2017. Specific medical records including initial and final pure tone audiometry (PTA), and canal paresis value were reviewed. Abbreviated MRI was performed in all patients. RESULTS: Fifteen patients showed increased signal of labyrinth on FLAIR images and eleven revealed negative findings on MRI. Two patients showed an infarction in the anterior inferior cerebellar artery (AICA) territory and three exhibited vestibular schwannoma in the internal auditory canal. There were no significant differences in initial, final PTA, and hearing recovery between negative and labyrinthine abnormality groups on MRI. CONCLUSIONS: Our results show that isolated acute audiovestibular loss due to labyrinthitis is more common than other secondary causes including vestibular schwannoma or AICA infarction. However, MRI with a tailored, abbreviated protocol is strongly recommended in patients with isolated acute audiovestibular loss to identify the exact etiologies.