Radiology/Imaging of the Inner Ear Seminar

Early MRI Protocols to Understand Pathophysiology of Sudden Sensorineural Hearing Loss (SSNHL)

Date: Saturday, May 24, 2025

Time: 9-11AM PT, 12-2PM ET, 5-7PM UK, 6-8PM Germany

Meeting ID: 898 7910 7259
Passcode: 1942

Overview:

Sudden Sensorineural Hearing Loss (SSNHL) is a rapid onset hearing impairment, typically occurring in one ear, with an unknown origin in many cases. MRI (Magnetic Resonance Imaging) has emerged as a key imaging modality for diagnosing and understanding SSNHL’s pathophysiology. Early MRI protocols can help identify underlying causes such as abnormalities, tumors, or inflammation, and guide treatment decisions. Research into MRI-based protocols for SSNHL has the potential to identify pathophysiological mechanisms early in the disease process.

Objective:

The goal of this session is to review the current state of imaging for SSNHL and develop an early-stage MRI protocol to better understand its pathophysiology. The session will focus on current imaging techniques and how to improve early diagnosis and treatment through MRI advancements.

Session Agenda:

First Hour: Overview of SSNHL Diagnosis, HSA, and Speaker Presentations (9-10:10AM)

1. Introduction to SSNHL Diagnosis (9-9:05)

a. Definition and clinical presentation of SSNHL (William Slattery, M.D.)
b. Importance of early diagnosis and intervention (William Slattery, M.D.)
c. Current diagnostic tools (audiometric testing, MRI, CT scans) (William Slattery, M.D.)

2. Hearing Science Accelerator (HSA) (9:05-9:10)

a. Overview of HSA for SSNHL (William Slattery, M.D.)

3. Research Questions 2 and 3 (9:10-9:15)

a. Open discussion of imaging research questions:

I. Q2: Can acute MRI predict response to treatment? Is acute MRI safe for an injured ear. Can acute MRI help our understanding of pathophysiology of acute ear disease?

a. Is the MRI noise safe in the setting of acute inner ear hearing loss?

b. Is it possible to get a quiet inner-ear protocol?

c. Can early MRI help us determine etiology of SSNHL? Diagnostic tests protocols for intralabyrintine, inflammation, infection, ischemia, hydrops, bleeding or schwannoma would be required.

d. Can MRI determine the role of cochlear hydrops in SSNHL?

II. Q3: How can we use functional and other imaging studies to identify the site of lesion, better predict prognosis or treatment protocol?

a. Would earlier testing within (72 hours of onset) help?

b. Would a natural history study of SSNHL help?

c. Does the pattern of SSNHL on audiometric testing predict treatment response?

d. A standardized testing protocol would allow comparison of standard data and potential a central registry for SSNHL. The following test should be included in such a testing protocol.

e. Behavioral audiogram: pure tones averages (PTA) 250 Hz to 8 kHz, air and bone conduction, word recognition scores, tympanometry, acoustic reflexes

1. Extended high-frequency audiogram if possible – up to 18 kHz

2. Distortion product otoacoustic emissions (DPOAE)

3. Electrocochleography (ECoG)

4. Vestibular evoked myogenic potentials (VEMPs) at 250 and 500 Hz

4. Speaker Presentations (9:15-10:10)

a. Experts present on the latest advancements in SSNHL research

- - - - John Butman, M.D., PhD (Topic: FLAIR imaging to monitor inner ear inflammation) (9:15-9:25)
        
        Bryan Ward, M.D. (Topic: 1.5 vs. 3.0 vs 7t imaging) (9:25-9:35)
        
        Akira Ishiyama, M.D. (Topic: Delayed imaging protocol and its effect on inner ear) (9:35-9:45)
        
        John Go, M.D. (Topic: Imaging of Meniere’s Disease) (9:45-9:55)
        
        Amy Juliano, M.D. (Topic: Timing of MRI with onset of disease) (9:55-10:05)
        
        Questions (10:05-10:10)