Conclusions: The best criterion to decide which patient with asymmetric hearing loss should be referred to MRI is based on the average bone conduction threshold difference at multiple (two or three) higher frequencies. The extent of the average threshold difference between ears that is used as a cutoff will mainly depend on treatment modality and (eventually) on resource costs and on the burden of Gadolinium-enhanced magnetic resonance imaging. Results of ABR can have little added value when only patients with a unilateral abnormal ABR at the worse hearing ear are referred to MRI. However, a lower sensitivity must then be accepted. (Source: Otology and Neurotology)
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