Asymmetric Hearing Loss as a Population Screening Signal for Vestibular Schwannoma: A Number-Needed-to-Scan Analysis Using NHANES and SEER

Asymmetric sensorineural hearing loss (SNHL) is the principal audiometric trigger for magnetic resonance imaging (MRI) to exclude vestibular schwannoma (VS). Although multiple audiometric referral criteria exist, the population-level burden of applying them has not been quantified....

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This analysis provides population-level data to refine MRI referral thresholds for asymmetric sensorineural hearing loss; audiologists and ENTs should review the specific number-needed-to-scan figures when they are published in full to inform referral criteria.

Establishing evidence-based MRI referral triggers for asymmetric sensorineural hearing loss could reduce unnecessary imaging costs while ensuring vestibular schwannomas are not missed.

1. 01Used NHANES (national hearing survey) and SEER (cancer registry) data to model vestibular schwannoma screening yield.
2. 02Number-needed-to-scan analysis quantifies how many MRIs are required to detect one vestibular schwannoma via asymmetric SNHL screening.
3. 03Asymmetric sensorineural hearing loss is a commonly used but variably defined MRI referral trigger.
4. 04Findings could inform cost-effectiveness of population-level or clinic-level screening protocols.
5. 05Large national datasets strengthen generalizability but retrospective linkage has inherent limitations.

PMID

42660352

DOI

10.1016/j.wneu.2026.125276.

Journal

World Neurosurgery

Publication type

research_article

Evidence level

2b

Population

General U.S. adult population with asymmetric sensorineural hearing loss, modelled using NHANES and SEER registry data

Intervention

Asymmetric sensorineural hearing loss as an MRI referral trigger for vestibular schwannoma screening

Comparator

Population base rate of vestibular schwannoma (SEER)