In some patients with clinical suspicion of otospongiosis, it may suggest alternate diagnoses to explain hearing loss. [31,32]. Administration of IV contrast is usually not beneficial for assessment of temporal bone. CT Head Relative to MRI, CT head is much less sensitive in detecting or excluding retrocochlear pathology to account for the sensorineural component of the hearing loss [17]. CTA Head There is no evidence to support use of CTA in the initial workup of patients presenting with mixed hearing loss. Hearing Loss and/or Vertigo MRI Head and Internal Auditory Canal MRI obtained using IAC protocol can be helpful in looking for any retrocochlear pathology responsible for a sensorineural component of the hearing loss. In case IV contrast is administered, punctate enhancement can be seen within the bony otic capsule in the presence of otospongiosis [2]. MRA Head There is no evidence to support use of MRA in the initial workup of patients presenting with mixed hearing loss. MR Venography Head There is no evidence to support use of MRV in the initial workup of patients presenting with mixed hearing loss. Variant 5: Congenital hearing loss or total deafness or cochlear implant candidate. Surgical planning. CT Temporal Bone High-spatial resolution provided by CT of the temporal bone is valuable prior to cochlear implantation surgery in patients with profound hearing loss. It can provide preoperative delineation of underlying cochlear malformation in patients with congenital hearing loss, detect changes of otospongiosis, suggest round window occlusion, identify labyrinthitis ossificans, congenital bony fusion of the ossicles, and alert the surgeon regarding underlying otomastoiditis or variant anatomy (such as that of the facial nerve) [33,34]. It can also delineate the size of cochlear and vestibular aqueducts, alerting the surgeon for possibility of intraoperative cerebrospinal fluid gusher [24,35,36].
Hearing Loss and or Vertigo. In some patients with clinical suspicion of otospongiosis, it may suggest alternate diagnoses to explain hearing loss. [31,32]. Administration of IV contrast is usually not beneficial for assessment of temporal bone. CT Head Relative to MRI, CT head is much less sensitive in detecting or excluding retrocochlear pathology to account for the sensorineural component of the hearing loss [17]. CTA Head There is no evidence to support use of CTA in the initial workup of patients presenting with mixed hearing loss. Hearing Loss and/or Vertigo MRI Head and Internal Auditory Canal MRI obtained using IAC protocol can be helpful in looking for any retrocochlear pathology responsible for a sensorineural component of the hearing loss. In case IV contrast is administered, punctate enhancement can be seen within the bony otic capsule in the presence of otospongiosis [2]. MRA Head There is no evidence to support use of MRA in the initial workup of patients presenting with mixed hearing loss. MR Venography Head There is no evidence to support use of MRV in the initial workup of patients presenting with mixed hearing loss. Variant 5: Congenital hearing loss or total deafness or cochlear implant candidate. Surgical planning. CT Temporal Bone High-spatial resolution provided by CT of the temporal bone is valuable prior to cochlear implantation surgery in patients with profound hearing loss. It can provide preoperative delineation of underlying cochlear malformation in patients with congenital hearing loss, detect changes of otospongiosis, suggest round window occlusion, identify labyrinthitis ossificans, congenital bony fusion of the ossicles, and alert the surgeon regarding underlying otomastoiditis or variant anatomy (such as that of the facial nerve) [33,34]. It can also delineate the size of cochlear and vestibular aqueducts, alerting the surgeon for possibility of intraoperative cerebrospinal fluid gusher [24,35,36].