Inner Ear Hemorrhage Detected by MRI Linked to Worse Prognosis in Sudden Sensorineural Hearing Loss: Study Shows

Patients with evidence of hemorrhage on MRI experienced more severe initial hearing loss—particularly at speech frequencies (0.5–2 kHz)—along with poorer recovery outcomes and increased symptoms, such as dizziness, compared to those without hemorrhage. The findings emphasize the value of MRI in detecting inner ear abnormalities and offer important prognostic insights to guide clinical management.

SSNHL is characterized by a rapid onset of unexplained hearing loss, typically occurring over 72 hours. The condition is considered a medical emergency, as timely diagnosis and intervention are critical for optimal hearing recovery. However, determining the underlying cause and likely prognosis has remained challenging in clinical settings.

Against the above background, Shiyao Min, NHC Key Laboratory of Hearing Medicine Research, China, and colleagues aimed to investigate the link between MRI-detected inner ear hemorrhage and the prognosis and symptoms of SSNHL. For this purpose, the researchers enrolled 220 patients who were asked to undergo MRI and hearing tests.

The study led to the following findings:

• Patients with MRI-detected inner ear hemorrhage had significantly more severe hearing loss compared to those without hemorrhage.
• Differences in hearing before and after treatment were more pronounced in the hemorrhage group.
• The recovery of hearing at speech frequencies (0.5, 1, 2 kHz) was better in the group without inner ear hemorrhage.
• The non-hemorrhage group experienced fewer symptoms of dizziness and had a better prognosis for dizziness.

The study authors emphasize the pivotal role of MRI in identifying the location of inner ear hemorrhage and predicting the prognosis of sudden sensorineural hearing loss. The presence of inner ear hemorrhage on MR imaging provides valuable insights into the severity of symptoms and the potential for recovery in SSNHL patients. As observed, patients with inner ear hemorrhage experienced more severe symptoms and worse outcomes, particularly hearing loss and dizziness.

The study found a significant correlation between dizziness and inner ear hemorrhage, supporting prior research that links the presence of hemorrhage to a poorer prognosis in SSNHL.

"These findings emphasize the importance of MRI not only in identifying inner ear abnormalities but also in helping clinicians predict the disease course and tailor treatment strategies accordingly," the authors concluded.

Reference:

Min, S., Wang, J., Zhao, H., Chi, F., & Gao, N. (2025). MRI evidence of inner ear hemorrhage in prognostic assessment of sudden sensorineural hearing loss. American Journal of Otolaryngology, 104620. https://doi.org/10.1016/j.amjoto.2025.104620