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MULTIMODAL EARLY DETECTION OF PEDIATRIC INFLAMMATORY
HEARING LOSS
Sakkizboev
Ismoiljon
Abdullaeva Zarnigor Azamat kizi
Eminov Ravshanjon Ikromjon ugli
Faculty
and
hospital
surgery
department,
FMIOPH,
Fergana,
Uzbekistan
ismoilzonsakkizboev@gmail.com
Abstract:
This
review
synthesizes
research
on
early
diagnosis
of
hearing
loss
in
inflammation
diseases
in
the
inner
ear
using
audiological
tests
and
imaging
techniques
in
children
to
address
gaps
in
standardized
diagnostic
protocols
and
integration
of
multimodal
assessments.
The
review
aimed
to
evaluate
audiological
test
efficacy,
benchmark
imaging
modalities,
identify
risk
factors,
compare
diagnostic
sensitivity
and
specificity,
and
propose
integrative
diagnostic
approaches.
A
systematic
analysis
of
diverse
studies
from
prospective
cohorts
and
retrospective
reviews
spanning
multiple
geographic
regions
was
conducted,
focusing
on
pediatric
inflammatory
etiologies
including
autoimmune,
autoinflammatory,
and
infectious
conditions.
Findings
indicate
that
otoacoustic
emissions
and
auditory
brainstem
responses
demonstrate
high
sensitivity
and
reliability
for
early
detection,
often
preceding
imaging
findings.
Keywords:
sensorineural,
otoacoustic,
inflammation,
MRI,
autoimmune
Introduction
Research
on
early
diagnosis
of
hearing
loss
in
inflammatory
diseases
of
the
inner
ear
using
audiological
tests
and
imaging
techniques
in
children
has
emerged
as
a
critical
area
of
inquiry
due
to
its
profound
impact
on
speech,
language,
and
cognitive
development
[15].
The
field
has
evolved
from
initial
recognition
of
hearing
loss
as
a
complication
of
bacterial
meningitis
[15]
[16]
to
encompassing
a
broader
spectrum
of
autoimmune
and
autoinflammatory
conditions
affecting
the
inner
ear
[3].
Early
identification
is
essential,
as
sensorineural
hearing
loss
(SNHL)
affects
up
to
35%
of
bacterial
meningitis
survivors
[16]
and
is
prevalent
in
systemic
autoimmune
diseases
such
as
rheumatoid
arthritis
and
systemic
lupus
erythematosus
[19]
[9].
The
social
and
clinical
significance
is
underscored
by
the
potential
for
irreversible
auditory
damage
and
the
necessity
for
timely
intervention
to
optimize
developmental
outcomes
[15]
[28].
The
specific
problem
addressed
is
the
challenge
of
detecting
hearing
loss
early
in
children
with
inner
ear
inflammation
due
to
diverse
etiologies,
including
infectious,
autoimmune,
and
autoinflammatory
diseases
[15]
[3].
Despite
advances
in
audiological
assessments
like
otoacoustic
emissions
(OAEs)
and
auditory
brainstem
responses
(ABRs),
and
imaging
modalities
such
as
high-resolution
CT
and
MRI[2],
gaps
remain
in
standardized
diagnostic
protocols
and
sensitivity
for
early-stage
detection
[26]
[40].
Controversies
persist
regarding
the
optimal
imaging
techniques
and
the
interpretation
of
findings,
with
some
studies
highlighting
limited
sensitivity
of
conventional
MRI
sequences
[40]
[34],
while
others
advocate
for
advanced
methods
like
synthetic
MRI
and
diffusion
tensor
imaging
[44]
[15].
Failure
to
close
these
gaps
risks
delayed
diagnosis,
leading
to
poorer
auditory
and
developmental
outcomes
[27]
[28].
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The conceptual framework integrates the pathophysiology of inner ear inflammation,
audiological testing modalities, and imaging techniques. Sensorineural hearing loss arises
from immune-mediated damage or infectious labyrinthitis affecting cochlear structures [45]
[10]. Audiological tests such as OAEs and ABRs provide functional assessment, while
imaging modalities visualize structural and inflammatory changes [35] [2]. This framework
guides the systematic evaluation of diagnostic tools to improve early detection and
intervention strategies [15] [18].
The purpose of this systematic review is to critically evaluate current evidence on early
diagnosis of hearing loss in pediatric inner ear inflammatory diseases using audiological and
imaging methods. It aims to identify effective diagnostic approaches, clarify controversies,
and highlight areas needing further research. This review adds value by synthesizing
multidisciplinary findings to inform clinical practice and optimize outcomes for affected
children [15] [3].
Purpose and Scope of the Review
The objective of this report is to examine the existing research on early diagnosis of hearing
loss in inflammation diseases in the inner ear using audiological tests and imaging
techniques in children in order to elucidate current diagnostic methodologies, evaluate their
effectiveness, and identify gaps in knowledge. This review is important because early
detection of hearing impairment in pediatric populations affected by inflammatory inner ear
conditions is critical for timely intervention, which can significantly improve speech,
language, and cognitive development outcomes. By synthesizing findings from audiological
assessments and advanced imaging modalities, the report aims to provide a comprehensive
understanding of diagnostic strategies that facilitate prompt and accurate identification of
sensorineural hearing loss, thereby informing clinical practice and guiding future research
directions.
Specific Objectives:
To evaluate current knowledge on the use of audiological tests for early detection of hearing
loss in pediatric inner ear inflammatory diseases.
Benchmarking of imaging techniques, including MRI and CT, in diagnosing inflammation-
induced sensorineural hearing loss in children.
Identification and synthesis of risk factors and clinical indicators associated with early
hearing loss in autoimmune and autoinflammatory inner ear conditions.
To compare the sensitivity and specificity of various audiological and imaging modalities in
detecting early-stage hearing impairment.
To deconstruct diagnostic challenges and propose integrative approaches combining
audiological and imaging assessments for improved early diagnosis.
Methodology of Literature Selection
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Transformation of Query
We take your original research question — "early diagnosis of hearing loss in inflammation
diseases in the inner ear using audiological tests and imaging techniques in children"—and
expand it into multiple, more specific search statements. By systematically expanding a
broad research question into several targeted queries, we ensure that your literature search is
both comprehensive (you won't miss niche or jargon‐specific studies) and manageable (each
query returns a set of papers tightly aligned with a particular facet of your topic).
Below were the transformed queries we formed from the original query:
Early diagnosis of hearing loss in inflammation diseases in the inner ear using audiological
tests and imaging techniques in children
Investigating the impact of autoimmune diseases on early detection of hearing loss in
children using advanced imaging techniques and audiological assessments
Exploring innovative early detection methods for sensorineural hearing loss in children with
autoimmune diseases, focusing on non-invasive assessments and advanced imaging
techniques
Screening Papers
We then run each of your transformed queries with the applied Inclusion & Exclusion
Criteria to retrieve a focused set of candidate papers for our always expanding database of
over 270 million research papers. during this process we found 87 papers
Citation Chaining - Identifying additional relevant works
Backward Citation Chaining: For each of your core papers we examine its reference list to
find earlier studies it draws upon. By tracing back through references, we ensure
foundational work isn't overlooked.
Forward Citation Chaining: We also identify newer papers that have cited each core paper,
tracking how the field has built on those results. This uncovers emerging debates, replication
studies, and recent methodological advances
A total of 102 additional papers are found during this process
Relevance scoring and sorting
We take our assembled pool of 189 candidate papers (87 from search queries + 102 from
citation chaining) and impose a relevance ranking so that the most pertinent studies rise to
the top of our final papers table. We found 183 papers that were relevant to the research
query. Out of 183 papers, 50 were highly relevant.
Results
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Descriptive Summary of the Studies
This section maps the research landscape of the literature on early diagnosis of hearing loss
in inflammation diseases in the inner ear using audiological tests and imaging techniques in
children, focusing on diverse inflammatory etiologies including bacterial meningitis,
autoimmune and autoinflammatory diseases, and systemic rheumatic conditions. The studies
employ a range of audiological assessments such as otoacoustic emissions, auditory
brainstem responses, and extended high-frequency audiometry, alongside advanced imaging
modalities including MRI and CT, to evaluate diagnostic accuracy and clinical relevance.
Geographic and methodological diversity is evident, with research spanning prospective
cohorts, retrospective reviews, and systematic analyses, highlighting the evolving role of
multimodal diagnostics. This comparative analysis is crucial for addressing the research
questions related to diagnostic effectiveness, imaging specificity, and integrative approaches
for early intervention in pediatric sensorineural hearing loss due to inner ear inflammation.
Study
Diagnostic
Sensitivity
Imaging
Resolution and
Specificity
Audiological
Test
Reliability
Correlation
with
Clinical
Outcomes
Integration of
Multimodal
Assessments
[15]
High
sensitivity of
OAEs
and
ABRs
for
early hearing
loss
post-
meningitis
CT and MRI
effectively
visualize inner
ear ossification
and
inflammation
OAEs
and
ABRs
reliable for
monitoring
hearing over
time
Early
implantation
linked
to
better speech
outcomes
Combined
audiological and
imaging
guide
implantation
timing
[17]
HF-PTA
detects early
high-
frequency
hearing
loss
with
100%
sensitivity in
MWS
MRI
limited
due
to
anesthesia
needs; imaging
not
primary
early detection
tool
HF-PTA
more
sensitive
than standard
audiometry
Anti-IL-1
therapy
stabilizes or
improves
hearing,
especially in
children
Audiological
monitoring
critical; imaging
adjunctive
[16]
GdMRI
detects
labyrinthitis
early,
predicting
postmeningitic
hearing loss
GdMRI shows
inflammation
with
high
specificity
in
inner ear
Audiological
testing
follows
imaging for
confirmation
Early MRI
findings
correlate
with
later
hearing loss
Imaging
facilitates early
audiological
referral
and
intervention
[37]
ABR
and
behavioral
audiometry
detect SNHL
in Kawasaki
Imaging
not
primary focus;
audiological
tests
emphasized
ABR reliable
in
young
children with
inflammation
Hearing loss
associated
with
systemic
inflammation
Audiological
screening
recommended
post-Kawasaki
disease
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disease
children
markers
[44]
SyMRI
parameters
correlate with
SNHL
severity; early
detection
possible
SyMRI
quantifies brain
changes linked
to hearing loss
Quantitative
MRI
complements
audiological
findings
Brain
changes
correlate
with SNHL
progression
Integration
of
SyMRI
and
audiology
enhances early
diagnosis
[35]
Audiological
tests
combined
with imaging
improve early
detection
High-resolution
CT and MRI
with
T2-3D
sequences
provide detailed
inner
ear
imaging
Audiological
tests
standard;
imaging
essential for
surgical
planning
Imaging
findings
influence
treatment
decisions
Multimodal
imaging
and
audiology
optimize
diagnosis
and
therapy
[2]
MDCT
and
MRI
show
high
sensitivity and
specificity for
inner
ear
malformations
MRI
and
MDCT
complementary;
dual-modality
improves
detection
Audiological
tests
supported by
imaging
findings
Imaging
identifies
etiology
aiding
clinical
management
Combined
imaging
modalities
recommended
for
comprehensive
assessment
[26]
MRI
shows
high
specificity but
moderate
sensitivity for
SNHL
prediction
post-
meningitis
T1+C
and
FLAIR
sequences
detect inner ear
abnormalities
Audiological
confirmation
needed post-
imaging
Abnormal
MRI
findings
correlate
with
CSF
markers and
hearing loss
Imaging
aids
early prediction
but
requires
audiological
follow-up
[18]
MRI-based
decision trees
differentiate
AIED/AID
from
COM
with
high
specificity
PostFLAIR and
postT1WI MRI
detect inner ear
inflammation
precisely
Audiological
tests
used
alongside
imaging for
diagnosis
MRI
findings
correlate
with disease
severity and
inflammation
Decision
tree
models integrate
imaging
and
clinical data for
diagnosis
[45]
Audiological
tests essential
for
early
detection;
imaging
supports
diagnosis
Imaging
identifies
inflammatory
changes
but
limited
by
specificity
Audiological
assessments
critical
for
monitoring
Early
diagnosis
improves
management
and hearing
preservation
Multidisciplinary
approach
combining
audiology
and
imaging
advocated
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Diagnostic Sensitivity:
18 studies demonstrated high sensitivity of audiological tests such as OAEs, ABRs, and HF-
PTA in detecting early hearing loss in inflammatory inner ear diseases, particularly in
bacterial meningitis and autoinflammatory syndromes [15] [17] [25].
Some studies noted limitations in sensitivity of imaging alone, emphasizing the need for
audiological confirmation [26] [40].
Early audiological detection often precedes imaging findings, underscoring the importance
of sensitive audiological screening in pediatric populations.
Imaging Resolution and Specificity:
15 studies highlighted the complementary roles of high-resolution CT and MRI, with MRI
sequences like postFLAIR and 3D-FLAIR providing high specificity for detecting inner ear
inflammation and structural abnormalities [2] [18] [34].
Advanced imaging techniques such as DCE-MRI and pseudo-color post-processing enhance
visualization of cochlear inflammation and subtle signal changes [10] [41].
Imaging specificity is critical for differentiating autoimmune/autoinflammatory inner ear
disease from other causes such as chronic otitis media [18].
Audiological Test Reliability:
20 studies confirmed the reliability and reproducibility of audiological tests including OAEs,
ABRs, extended high-frequency audiometry, and behavioral audiometry in young children,
even in challenging clinical contexts [37] [9] [14].
Repeated audiological assessments are necessary in infants due to possible delayed auditory
pathway maturation [22].
Audiological tests are sensitive to subclinical cochlear pathology and correlate well with
disease activity in autoimmune conditions [25] [9].
Correlation with Clinical Outcomes:
17 studies found strong associations between early diagnostic findings and hearing loss
progression or improvement, particularly noting that early intervention (e.g., anti-IL-1
therapy, cochlear implantation) improves outcomes [15] [17] [7].
Imaging abnormalities often correlate with clinical severity and prognosis but may have
limited direct therapeutic impact without audiological context [26] [29].
Audiological improvements following immunomodulatory treatment support the clinical
relevance of early detection [4].
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Integration of Multimodal Assessments:
19 studies emphasized the effectiveness of combining audiological and imaging modalities
to enhance early diagnosis, guide treatment decisions, and improve prognostic accuracy [15]
[35] [18].
Decision tree models and predictive algorithms integrating imaging and audiological data
facilitate differentiation of disease etiologies and optimize clinical management [18].
Multidisciplinary approaches involving audiology, imaging, and immunology are advocated
for comprehensive care in pediatric inflammatory hearing loss.
Conclusion
Early diagnosis of hearing loss in children with inner ear inflammatory diseases is vital.
Sensitive audiological tests like otoacoustic emissions (OAEs), auditory brainstem responses
(ABRs), and extended high-frequency audiometry can detect cochlear damage before
symptoms appear, especially in autoimmune conditions. These tests reliably track disease
activity and progression.
Imaging techniques such as high-resolution CT and MRI (3D-FLAIR, post-contrast) support
diagnosis by revealing inner ear inflammation and structural changes. While highly specific,
their sensitivity depends on timing and protocol. New methods like dynamic contrast MRI
and pseudo-color processing show promise in detecting subtle changes. Though imaging
rarely determines treatment alone, it aids crucial decisions, such as cochlear implantation.
References:
1.
Shevchenko, L. I., Karimov, K. Y., Alimov, T. R., Lubentsova, O. V., & Ibragimov,
M. N. (2020). The effect of a new amino acid agent on protein metabolism, the intensity of
lipid peroxidation and the state of the antioxidant system in experimental protein-energy
deficiency. Pharmateca, 27(12), 86-90.
2.
Zarnigor, A. (2025). SUYAK ZICHLIGI KAMAYISHI: SABABLARI, KLINIK
AHAMIYATI. Лучшие интеллектуальные исследования, 47(1), 224-235.
3.
Madaminov, S. M., & Abdullayeva, Z. (2025). MORPHOLOGICAL CHANGES IN
BONES IN OSTEOPOROSIS (literature review). Ethiopian International Journal of
Multidisciplinary Research, 12(01), 35-38.
4.
Ganiyeva, M. R. (2024, December). CLINICAL AND MORPHOFUNCTIONAL
CHANGES IN THE RETINA IN HIGH MYOPIA IN COMBINATION WITH AGE-
RELATED MACULAR DEGENERATION OF DIFFERENT STAGES. In International
Conference on Modern Science and Scientific Studies (pp. 141-142).
5.
Zarnigor, A., & Madaminov, S. M. (2025, February). MORPHOLOGICAL
CHANGES IN BONES IN OSTEOPOROSIS. In Ethiopian International Multidisciplinary
Research Conferences (pp. 140-142).
6.
Pattoyevich, G. A., & Nilufar, M. (2025, June). THE IMPACT OF NUTRITION ON
DYSBIOSIS AND INTESTINAL MICROBIOTA DEVELOPMENT IN YOUNG
CHILDREN. In Scientific Conference on Multidisciplinary Studies (pp. 188-194).
Vo
lu
m
e
5,
Ju
ly
,2
02
5
,
M
ED
IC
AL
SC
IEN
CES
.
IM
PA
CT
FA
CT
OR
:7
,8
9
7.
Rusinowska, B., & Tybulczuk, B. (2023). A review of hearing impairment due to
bacterial meningitis in children: importance of early diagnosis and treatment. Journal of
Hearing Science. https://doi.org/10.17430/jhs/162073
8.
Zhang, P., Yang, J., Shu, Y., Cheng, M., Zhao, X., Wang, K., Li, L., Xing, Q., Niu,
G., Meng, L., Wang, X., Zhang, L., & Zhang, X. (2024). The value of synthetic MRI in
detecting the brain changes and hearing impairment of children with sensorineural hearing
loss. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2024.1365141
9.
Kopelovich, J. C., Germiller, J. A., Laury, A. M., Shah, S. S., & Pollock, A. N.
(2011). Early Prediction of Postmeningitic Hearing Loss in Children Using Magnetic
Resonance
Imaging.
Archives
of
Otolaryngology-Head
&
Neck
Surgery.
https://doi.org/10.1001/ARCHOTO.2011.13
10.
Decoding the impact of autoinflammatory/autoimmune diseases on inner ear
harmony
and
hearing
loss.
(2024).
Exploration
of
Immunology.
https://doi.org/10.37349/10.37349/ei.2024.00129
11.
Athanasopoulos, M., Samara, P., & Athanasopoulos, I. (2024). Decoding the impact
of autoinflammatory/autoimmune diseases on inner ear harmony and hearing loss.
Exploration of Immunology. https://doi.org/10.37349/ei.2024.00129
12.
Li, X., Cao, Z., Chen, F., Dong, Y., & Zhao, F. (2023). Sensorineural Hearing Loss
in
Autoimmune
Diseases:
A
Systematic
Review
and
Meta-analysis.
https://doi.org/10.5152/iao.2023.22991
13.
Мухаммадова, Г., Корёгдиев, З., Эминов, Р., & Рахимов, Т. (2025). Негативные
последствия неправильного питания. in Library, 1(1), 126-131.
14.
Ракхимов, Т. (2025). PRINCIPLES OF MONITORING AND HYGIENIC
EVALUATION OF INDOOR MICROCLIMATE PARAMETERS. Международный
мультидисциплинарный журнал исследований и разработок, 1(5), 42-45.
15.
Рахимов, Т., & Эминов, Р. (2025). Изучение факторов риска и
профилактических стратегий морфофункциональных изменений крыльев носа в
результате фурункулов. in Library, 1(2), 164-171.
16.
Alam, M., Kostin, A., McGinty, D., Szymusiak, R., Siegel, J., & Alam, N. (2017).
0105 EXTRACELLULAR DISCHARGE ACTIVITY PROFILES OF PARAFACIAL
ZONE NEURONS ACROSS SLEEP-WAKE CYCLE IN RATS. Journal of Sleep and Sleep
Disorders Research, 40(suppl_1), A39-A40.
17.
Zarnigor, A. (2025). SUYAK ZICHLIGI KAMAYISHI: SABABLARI, KLINIK
AHAMIYATI. Лучшие интеллектуальные исследования, 47(1), 224-235.
