The acute vestibular syndrome: prevalence of new hearing loss and its diagnostic value.
Eur Arch Otorhinolaryngol
; 281(4): 1781-1787, 2024 Apr.
Article
in En
| MEDLINE
| ID: mdl-37943315
ABSTRACT
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Nystagmus, Pathologic
/
Stroke
/
Deafness
/
Hearing Loss
Limits:
Humans
Language:
En
Journal:
Eur Arch Otorhinolaryngol
Year:
2024
Document type:
Article