Evaluating Abnormal MRI in Asymmetric Sensorineural Hearing Loss

Are there specific audiometric and clinical factors that can predict a positive MRI in the evaluation of asymmetric sensorineural hearing loss?

Bottom Line
Patients with an unexplained, asymmetric sensorineural hearing loss that includes a 15 dB or greater difference at 3 kHz, unilateral tinnitus, or dizziness/vertigo are significantly more likely to have an abnormal MRI scan than patients who do not meet these criteria.

Background: Asymmetric sensorineural hearing loss occurs in about 35% to 50% of the population, depending on how strictly “asymmetric” is defined. Prior studies indicate only 2% to 8% of patients with an asymmetric sensorineural hearing loss have a vestibular schwannoma.

Study design: Retrospective chart review of 451 patients with asymmetric sensorineural hearing loss who had an MRI scan over a seven-year period.

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