However, it may be helpful in assessing patency of the carotid artery if initial imaging raises suspicion of vascular involvement. MR Venography Head Although not used as the initial imaging modality, MRV may be helpful in assessing patency of jugular vein for surgical planning in patients with documented middle ear masses. Hearing Loss and/or Vertigo Variant 3: Acquired sensorineural hearing loss. Initial imaging. CT Temporal Bone CT of the temporal bone is insensitive in detection of soft-tissue abnormalities that commonly cause sensorineural hearing loss. Small size and proximity to the dense bone of inner ear structures and IAC also precludes visualization of intralabyrinthine or intracanalicular enhancement following IV contrast administration. It may demonstrate labyrinthine ossification [16] resulting from prior infection or give an indirect clue to presence of a vestibular schwannoma in the form of bony remodeling of the IAC. In post-traumatic sensorineural hearing loss, CT can demonstrate fractures extending across the otic capsule [2,13]. CT Head Contrast-enhanced head CT is a less-sensitive imaging modality to detect tumors, such as vestibular schwannomas [17], or assess the IAC, cerebellopontine angle cisterns, or the brainstem compared to MRI. CTA Head There is no evidence to support use of CTA in the initial workup of patients presenting with isolated sensorineural hearing loss. MRI Head and Internal Auditory Canal Imaging evaluation of patients presenting with sensorineural hearing loss involves detailed assessment of the cochlear contents, vestibulocochlear nerve, and auditory pathways. MRI is the imaging modality of choice for evaluating these soft-tissue structures [2,5,18-20].
Hearing Loss and or Vertigo. However, it may be helpful in assessing patency of the carotid artery if initial imaging raises suspicion of vascular involvement. MR Venography Head Although not used as the initial imaging modality, MRV may be helpful in assessing patency of jugular vein for surgical planning in patients with documented middle ear masses. Hearing Loss and/or Vertigo Variant 3: Acquired sensorineural hearing loss. Initial imaging. CT Temporal Bone CT of the temporal bone is insensitive in detection of soft-tissue abnormalities that commonly cause sensorineural hearing loss. Small size and proximity to the dense bone of inner ear structures and IAC also precludes visualization of intralabyrinthine or intracanalicular enhancement following IV contrast administration. It may demonstrate labyrinthine ossification [16] resulting from prior infection or give an indirect clue to presence of a vestibular schwannoma in the form of bony remodeling of the IAC. In post-traumatic sensorineural hearing loss, CT can demonstrate fractures extending across the otic capsule [2,13]. CT Head Contrast-enhanced head CT is a less-sensitive imaging modality to detect tumors, such as vestibular schwannomas [17], or assess the IAC, cerebellopontine angle cisterns, or the brainstem compared to MRI. CTA Head There is no evidence to support use of CTA in the initial workup of patients presenting with isolated sensorineural hearing loss. MRI Head and Internal Auditory Canal Imaging evaluation of patients presenting with sensorineural hearing loss involves detailed assessment of the cochlear contents, vestibulocochlear nerve, and auditory pathways. MRI is the imaging modality of choice for evaluating these soft-tissue structures [2,5,18-20].