Von Werdt, Moritz; Korda, Athanasia; Zamaro, Ewa; Wagner, Franca; Kompis, Martin; Caversaccio, Marco D; Mantokoudis, Georgios (2024). The acute vestibular syndrome: prevalence of new hearing loss and its diagnostic value. European archives of oto-rhino-laryngology, 281(4), pp. 1781-1787. Springer 10.1007/s00405-023-08296-z
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OBJECTIVES
To assess the prevalence of new hearing losses in patients with acute vestibular syndrome (AVS) and to start to evaluate its diagnostic value for the differentiation between peripheral and central causes.
DESIGN
We performed a cross-sectional prospective study in AVS patients presenting to our Emergency Department (ED) from February 2015 to November 2020. All patients received an MRI, Head-impulse test, Nystagmus test and Test of skew ('HINTS'), caloric testing and a pure-tone audiometry.
RESULTS
We assessed 71 AVS patients, 17 of whom had a central and 54 a peripheral cause of dizziness. 12.7% had an objective hearing loss. 'HINTS' had an accuracy of 78.9% to diagnose stroke, whereas 'HINTS' plus audiometry 73.2%. 'HINTS' sensitivity was 82.4% and specificity 77.8% compared to 'HINTS' plus audiometry showing a sensitivity of 82.4% and specificity of 70.4%. The four patients with stroke and minor stroke had all central 'HINTS'. 55% of the patients did not perceive their new unilateral hearing loss.
CONCLUSIONS
We found that almost one-eighth of the AVS patients had a new onset of hearing loss and only half had self-reported it. 'HINTS' plus audiometry proved to be less accurate to diagnose a central cause than 'HINTS' alone. Audiometry offered little diagnostic accuracy to detect strokes in the ED but might be useful to objectify a new hearing loss that was underestimated in the acute phase. Complete hearing loss should be considered a red flag, as three in four patients suffered from a central cause.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT) 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology |
UniBE Contributor: |
Von Werdt, Moritz, Korda, Athanasia, Zamaro, Ewa, Wagner, Franca, Kompis, Martin, Caversaccio, Marco, Mantokoudis, Georgios |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1434-4726 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Nov 2023 13:03 |
Last Modified: |
16 Mar 2024 00:13 |
Publisher DOI: |
10.1007/s00405-023-08296-z |
PubMed ID: |
37943315 |
Uncontrolled Keywords: |
Acute vestibular syndrome HINTS plus Hearing loss Vestibular stroke |
BORIS DOI: |
10.48350/188765 |
URI: |
https://boris.unibe.ch/id/eprint/188765 |
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