The Clinical Value of Periventricular White Matter Hyperintensity on MRI in Sudden Sensorineural Hearing Loss

Ann Otol Rhinol Laryngol. 2022 Mar;131(3):244-251. doi: 10.1177/00034894211018925. Epub 2021 May 25.

Abstract

Objectives: To assess the clinical value of periventricular white matter hyperintensity (PWMH) found on brain magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL).

Methods: In this prospective study, 115 patients who were diagnosed with SSNHL aged between 55 and 75 years were analyzed. All subjects underwent brain MRI and were divided into a PWMH and control groups, depending on the presence of PWMH on MRI. PWMH was subdivided into 3 groups according to severity. Pure-tone average results and hearing gain were compared between the 2 groups before treatment and 2 months after treatment. Hearing improvement was assessed using Sigel's criteria.

Results: A total of 106 patients (43 in the PWMH group and 63 in the control group) finally completed the 2-month follow-up. Average hearing gain in the PWMH group was significantly higher than in the control group (34.8 ± 20.3 and 25.9 ± 20.3, respectively, P = .029). PWMH score 1 showed significantly better hearing levels and hearing gain compared to PWMH score 3 and the control group. Multivariate analysis revealed that younger age, better initial hearing level, and the presence of PVWM score 1 were associated with good recovery.

Conclusions: The presence of PWMH score 1 on brain MRI in patients with SSNHL was associated with better treatment response and was a good prognostic factor in a multivariate analysis while the hearing recovery in more severe PWMH (scores 2, 3) was not different from the control group.

Keywords: magnetic; recovery rate; resonance; sudden sensorineural hearing loss; white matter hyperintensity.

MeSH terms

  • Aged
  • Case-Control Studies
  • Female
  • Hearing Loss, Sensorineural / diagnostic imaging*
  • Hearing Loss, Sensorineural / pathology
  • Hearing Loss, Sensorineural / therapy
  • Hearing Loss, Sudden / diagnostic imaging*
  • Hearing Loss, Sudden / pathology
  • Hearing Loss, Sudden / therapy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Recovery of Function
  • White Matter / diagnostic imaging*
  • White Matter / pathology*