Differences Among Elderly Patients Having Asymmetric Sensorineural Hearing Loss With and Without Cerebellopontine Angle Tumors

Abstract

Objective: Asymmetric sensorineural hearing loss (ASNHL) exhibits a higher prevalence among the elderly compared to younger individuals, yet optimal management remains subject to ongoing debate. We aimed to elucidate the clinical disparities among elderly patients with ASNHL, distinguishing between those with and without cerebellopontine angle (CPA) tumors. Methods: A retrospective analysis was conducted on elderly patients (aged ≥65 years) diagnosed with ASNHL who underwent magnetic resonance imaging (MRI) between January 2012 and December 2022 at our tertiary referral center. Results: A total of 119 patients were enrolled, with a median age of 71 years (range: 65-89 years). Among them, 11 patients (9.2%) exhibited abnormal MRI findings. In the CPA tumors group, vestibular schwannoma was the most prevalent abnormality (63.6%), with a mean growth rate of 0.53 mm/year (range: 0-1.33 mm/year). The prevalence of CPA tumors in patients with diabetes mellitus (DM) and ASNHL was significantly lower than in those without DM ( P = .021). Vertigo emerged as a significant associated symptom in cases with CPA tumors ( P = .011). However, there were no significant differences in mean hearing thresholds or asymmetry of hearing loss at individual frequencies between the 2 groups. Conclusions: Elderly patients with ASNHL and vertigo should undergo radiological assessment. Patients with DM exhibit a lower prevalence of CPA tumors than those without DM, warranting careful observation and follow-up due to the limited diagnostic yield of MRI. No discernible differences in audiometric patterns were detected between patients with and without CPA tumors.