Development of a diagnostic model to identify patients at high risk for cerebellopontine angle lesions

Author:

Hentschel MaykeORCID,Rovers Maroeska,Steens Stefan,Hannink Gerjon,Kunst Henricus

Abstract

Abstract Purpose To develop a diagnostic model to identify patients at high risk of a CPA lesion. Methods A consecutive cohort of patients with AAD referred by a general practitioner, who underwent their first MRI examination of the CPA between 2005 and 2015 was included. Demographics, symptoms, findings during physical examination, and pure-tone audiometry were used as potential predictors. The presence of a CPA lesion was used as outcome. Results We analyzed data of 2,214 patients, detecting 73 CPA lesions in 69 (3.1%) patients. The final model contained eleven variables, namely gender [male] [OR 1.055 (95% CI 0.885–1.905)], sudden onset of hearing loss [OR 0.768 (95% CI 0.318–0.992)], gradual onset of hearing loss [OR 1.069 (95% CI 0.500–1.450)], unilateral tinnitus [OR 0.682 (95% CI 0.374–0.999)], complaints of unilateral aural fullness [OR 1.006 (95% CI 0.783–2.155)], instability [OR 1.006 (95% CI 0.580–2.121)], headache [OR 0.959 (95% CI 0.059–1.090)], facial numbness [OR 2.746 (95% CI 0.548–11.085)], facial nerve dysfunction during physical examination [OR 1.024 (95% CI 0.280–3.702)], and asymmetry in BC at 1 kHz [OR 1.013 (95% CI 1.000–1.027)] and 4 kHz [OR 1.008 (95% CI 1.000–1.026)]. Conclusion The proposed diagnostic model is a first step in selecting patients with a high risk of a CPA lesion among those with AAD. It needs to be externally validated prior to its implementation in clinical practice.

Funder

zonmw

Publisher

Springer Science and Business Media LLC

Subject

General Medicine,Otorhinolaryngology

Reference35 articles.

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