• Wagner, Franca
• Zamaro, Ewa
• Mantokoudis, Georgios
• Caversaccio, Marco D.
• Korda, Athanasia
• Kompis, Martin
• Werdt, Moritz Von

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>

Topics

• phase
• laser emission spectroscopy
• size-exclusion chromatography