gadolinium enhanced mri came back negative / speculative questions

[insearchofantruth]

Greetings,

    Approximately two years ago I went to an ENT and complained of this right sided tinnitus. He had me tested by an audiologist, and the audiologist said I actually had left sided hearing loss. A gadolinium enhanced MRI was performed, and the results came back negative.

   For the last 2.5 years or so, the ringing has not progressed. The hearing loss has not progressed (to my knowledge). However, I have developed a very annoying but (usually)painless clicking/grating sensation on the right side of my jaw. It's as if my jaw is scraping against something. Additionally, my jaw will occasionally "crack" and leave me with a slight tingling sensation near my right temple. These symptoms are worrying to me, but at the same time I'm not eager to get stuffed in a tube and have more Gadolinium pumped through my veins. So , I decided to post the situation here -- any anecdote, personal feeling, etc. would be greatly appreciated.

   I guess three questions would be:

1. Do any scientific studies exist on the internet that give a statistical odd of a gadolinium mri not revealing an AN?
2. Could the audiologist suggesting that it's a left sided AN throw off the radiologist and lead to a misdiagnoses?
3. Could my AN perhaps be extremely tiny and slow growing?

Thank you! I appreciate any responses, and my thoughts go out to anyone who actually has been diagnosed with something.

[Jim Scott]

Hi ~

To answer your questions:

1. - I cannot offer a link to scientific studies that would prove whether an MRI using gadolinium for contrast has failed to identify an acoustic neuroma but from what I do know regarding MRI scans, and I've had many, I would speculate that the contrast agent would make even a tiny AN visible to the trained eye.  I would add that the radiologist reading the scan results would have to be alert to the slightest abnormality.  Some very small ANs have been overlooked but a doctor well acquainted with these benign tumors should be able to spot even a very small one.  Here, as in all the sciences, experience counts.   

2. - I don't see how.  The MRI scan will show a tumor wherever it is located. 

3.  Yes.  Some AN's are 'missed' on MRI scans due to their near-infinitesimal size but often tiny tumors give the patient perplexing symptoms. 

My suggestion is to consider seeking out a physician with extensive experience in acoustic neuromas and other skull-based tumors.  Explain your symptoms and submit to another MRI with contrast.  An experienced doctor who knows exactly where and what to look for should have no trouble seeing even a very small AN. 

Another suggestion is to send your MRI disc to the House Ear Institute in Los Angeles, California http://www.houseearclinic.com/

They have excellent doctors, are highly experienced with acoustic neuroma cases and will 'read' your MRI scan.   If a tumor is present they'll reply with a diagnosis and suggestion for how to proceed. The scan reading is free with no obligation.  Many of our members have availed themself of this service.

Others may have more suggestions but I trust these are useful.

Jim

[john1455]

insearchofantruth,

I am 100% certain that you have a TMJ disorder. However, your ear problems MAY NOT be related to that.  Before retiring after 32 years of dental practice, I treated TMJ disorders since 1984 and clicking and/or popping of the jaws is diagnostic of a TMJ problem. Normal joints function silently and when noises are heard during function, then that means something is not working right. The clicking is caused by a fibrous structure called the articular disk popping out of place (becoming dislocated) whenever your teeth come together and then popping back into joint when you open. Note that most people think the jaw becomes dislocated when opening rather than when closing (the opposite of what really happens). The purpose of the articular disk is to enable the mouth to open properly (at least 3 fingers wide) and to prevent bone to bone contact within the jaw joint. The most common causes of TMJ are deep overbites, loss of posterior vertical support making the upper and lower jaws overclose, retruded chins (Class II jaws), and having premolars extracted when braces were done. These conditions cause the condyles of the mandible (lower jaw) to become pushed too far posteriorly (backward) and superiorly (upward), which in turn forces the articular disk anteriorly (forward) and that causes a clicking or popping noise.

Since not all dentists know how to treat TMJ disorders, let alone diagnose it, you will need to look diligently for a dentist who really knows how to treat the condition. Many dentists who do not know how to treat TMJ do so by making the patient a splint to wear and that's it. That is NOT the way to properly treat TMJ so if this happens to you, then you are in the wrong office. If you do indeed have TMJ, then it can be corrected by a properly trained dentist. You are welcome to contact me if you have any questions about the TMJ area.

[MikeRad]

OK... first post so bear with me.  I went to the ENT with tinnitus on the RIGHT side in November of 2012.  Its still there today.  For the most part, I have gotten used to it. However, the ENT told me that there was a slight chance that the tinnitus could be the result of a tumor and recommended an MRI. 

When I got the MRI results it showed a 4MM AN on the LEFT side.  To this day I am asymptomatic on the left except some periodic tinnitus.  Sometimes I can hear a slight morse code like sound on the left.  I suspect this is the beginning of my symptoms. 

Back to your issue.  I have searched high and low for potential causes of my tinnitus on the right side.  I've tried cutting caffeine, artificial sweeteners, and many other recommendations some backed by science and probably some not.  One of them potential causes of tinnitus I ran across in my reading was TMJ.  If your jaw is popping and cracking, this could be a result of TMJ and not an undetected AN.  If I were in your place, I would go see my dentist and explain the popping and cracking on the right side and let him know of the tinnitus on the right as well.  If TMJ is the cause then treating hopefully better than treating an AN

Best wishes
-Mike