PREDICTING NEURORADIOLOGIC OUTCOME IN PATIENTS REFERRED FOR AUDIOVESTIBULAR DYSFUNCTION

PURPOSE: To relate clinical presentation and results of audiovestibula r testing to neuroradiologic outcome in patients with audiovestibular dysfunction. METHODS: We retrospectively reviewed the neuroimaging stu dies, results of audiometric and vestibular testing, and medical recor ds of 118 patients referred for imaging over a 2-year period for evalu ation of sensorineural hearing loss, dizziness, and/or vertigo, and to rule out acoustic neuroma. Patients' presentation and results of audi ometric and vestibular testing were associated with either a positive or negative neuroimaging outcome. Discriminant analysis was performed to identify variables related significantly to imaging results. Two-wa y cross-tabulation of these significant variables was performed to ass ess their sensitivity and specificity in predicting imaging outcome. R ESULTS: Fifteen (13%) of 118 patients had neuroimaging findings relate d to presenting symptoms. Discriminant analysis identified vertigo, di zziness, and dysequilibrium as corresponding to negative radiologic ou tcome. Nonvestibulocochlear cranial nerve involvement correlated signi ficantly with positive neuroimaging results. Of all audiovestibular te sting, only vestibular testing results correlated significantly with n euroimaging outcome. In conjunction with the results of vestibular tes ting, the symptoms and signs identified above yielded a sensitivity of 57% and specificity of 93% in predicting neuroradiologic results. In the absence of vestibular testing, sensitivity and specificity were 29 % and 98%, respectively. CONCLUSIONS: Clinical presentation and audiov estibular testing could not sensitively predict the outcome of neuroim aging in our cohort of patients referred for audiovestibular dysfuncti on.