Computed tomography and magnetic resonance imaging in pediatric unilateral and asymmetric sensorineural hearing loss.

OBJECTIVE

To compare temporal bone computed tomography (CT) with temporal bone and central nervous system magnetic resonance (MR) imaging in children with unilateral or asymmetric sensorineural hearing loss (SNHL).

DESIGN

Retrospective chart study.

SETTING

Tertiary-care children's hospital.

PATIENTS: A total of 131 children with unilateral or asymmetric SNHL, seen consecutively by a single practitioner over 36 months.

INTERVENTION: Imaging studies were read by a pediatric neuroradiologist and reviewed by the evaluating otolaryngologist.

MAIN OUTCOME MEASURE: Prevalence of clinically significant CT or MR imaging findings.

RESULTS

The prevalence of CT abnormalities was 35% for unilateral SNHL, 52% for asymmetric SNHL, and 41% for all patients together. The prevalence of MR imaging abnormalities was 25% for unilateral SNHL, 50% for asymmetric SNHL, and 30% for all patients together. Among 42 subjects who underwent both studies, there were 4 cases in which abnormalities were seen only on MR images and 9 cases in which abnormalities were seen only on CT scans.

CONCLUSIONS

Temporal bone and/or central nervous system abnormalities were detected in 42% of 131 patients. When both CT scans and MR images were obtained (n = 42), results were concordant in 69% of cases, and one imaging modality detected clinically significant abnormalities not identified by the other in 31% of cases. The ideal imaging algorithm for children with unilateral or asymmetric SNHL is controversial. We suggest that all children with unilateral or asymmetric SNHL have a high-resolution temporal bone CT scan and that brain and temporal bone MR imaging be obtained in select cases.