- Design
- Single-centre retrospective case series
- Population
- 84 patients with idiopathic acute unilateral audiovestibulopathy in South Korea
- Primary outcome
- 3D-FLAIR MRI positivity and correlation with vestibular function
- Effect
- MRI positive in 44 (52%); associated with lower posterior canal VOR gain (P = 0.028)
A retrospective Korean series of 84 patients with idiopathic acute unilateral audiovestibulopathy — sudden hearing loss with acute vestibular loss on the same side — found high signal on precontrast heavily T2-weighted 3D-FLAIR MRI in 44 (52%), most often in the vestibule and semicircular canals.
MRI positivity was associated with lower vestibulo-ocular reflex gain in the posterior canal, and signal intensity correlated with loss of canal function.
The finding supports a labyrinthine cause in many of these patients and gives MRI a role beyond excluding a vestibular schwannoma or stroke. It is a single-centre retrospective study, and the 3D-FLAIR sequence is not routine in many units.
- Request MRI with a 3D-FLAIR sequence of the inner ear for acute combined hearing and vestibular loss where available.
- Use video head impulse testing to measure canal function in each canal.
- Continue to exclude posterior circulation stroke in acute vestibular syndrome, especially with central signs.
- Note that a negative 3D-FLAIR does not exclude a labyrinthine cause.
Why it matters
It suggests a specific, visible labyrinthine lesion in about half of these patients.
Don't overread it
A single-centre retrospective series of 84 patients; the findings need confirmation before changing imaging protocols widely.
The statistics, in plain English
Associations reported with q values (adjusted for multiple comparisons) below 0.05 are less likely to be chance. Correlation between signal and canal function supports a link but cannot show cause.
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