A Systematic Review of Audiological Criteria Used to Determine the Need for MRI Screening in Patients With Suspected Vestibular Schwannoma

To evaluate the diagnostic accuracy of non-imaging screening tools used to guide magnetic resonance imaging (MRI) referral in adults with asymmetric sensorineural hearing loss undergoing investigation for suspected vestibular schwannoma (VS). DATABASES REVIEWED: Medline (via Ovid; 1946 to August 19, 2025), PubMed, Embase, Cochrane Library, and Scopus.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Audiologists should review whether their current audiological criteria for MRI referral in asymmetric sensorineural hearing loss align with the evidence-based thresholds identified in this systematic review; specific criteria changes depend on findings not fully available here but the review warrants close reading.

✦ Why It Matters ✦

Optimising non-imaging audiological screening criteria for vestibular schwannoma could reduce unnecessary MRI referrals and associated costs while ensuring true cases are not missed.

✦ Key Points ✦

01Systematic review evaluates diagnostic accuracy of audiological tests for MRI referral decisions in suspected vestibular schwannoma.
02Target population: adults with asymmetric sensorineural hearing loss (unequal hearing loss between ears).
03Findings could inform standardisation of referral criteria across audiology and ENT practice.
04Published in Otology & Neurotology, a peer-reviewed specialty journal.
05Non-imaging screening tools assessed may help avoid unnecessary MRI scans in low-risk patients.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Audiological criteria can be used to determine the need for MRI screening in patients with suspected vestibular schwannoma.

studypartially supported

Non-imaging audiological tests have diagnostic value in triaging patients with asymmetric sensorineural hearing loss for MRI.

studypartially supported

✦ Research metadata ✦

PMID: 42531485
DOI: 10.1097/MAO.0000000000004994.
Journal: Otology & Neurotology
Publication type: systematic_review
Evidence level: 1a
Population: Adults with asymmetric sensorineural hearing loss and suspected vestibular schwannoma
Intervention: Non-imaging audiological screening criteria for MRI referral
Comparator: MRI as reference standard for vestibular schwannoma diagnosis

Primary outcomes

Diagnostic accuracy of audiological criteria for MRI referral; Sensitivity and specificity of audiological tests for vestibular schwannoma detection

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