Hypothesis:Early diagnosis of vestibular schwannoma (VS) is critical in optimizing patient outcomes, and clinicians should have a low threshold for ordering MRI in patients with ASNHL.
When to perform a contrast-enhanced MRI—the gold standard for the diagnosis of VS—for a patient with ASNHL, unilateral tinnitus, unilateral aural fullness, or dizziness is often not so much solely based on the audiogram itself but on a constellation of clinical data, including the history, the age of the patient, the quality, duration, and frequency of the symptoms, history of noise exposure, family history of HL, as well as other audiometric parameters besides simply the pure-tone thresholds (the arguments over MRI vs ABR testing are well recognized and will not be discussed herein; for an excellent analysis proposing abandoning ABR testing, see Cueva1).
Kesser BW. Clinical Thresholds for When to Test for Retrocochlear Lesions: Con. Arch Otolaryngol Head Neck Surg. 2010;136(7):727-729. doi:10.1001/archoto.2010.100