Post Traumatic Labyrinthitis Ossificans
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I want to compare and contrast the right side from
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the left side on this patient who had left
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sided sensorineural hearing loss.
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In looking at the inner ear structures
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on the right side,
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the intralabyrinthine canal looks pretty good there's.
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Nice cochlear aperture.
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The medius of the cochlea looks fine.
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We have the basal turn, we have the middle turn,
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we have the apical turn.
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We have a normal vestibule and relatively normal
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looking lateral semicircular canals,
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as well as posterior and superior
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semicircular canals. Now,
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if the patient has dramatic sensorineural
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hearing loss that's unilateral,
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we may end up getting an MRI scan to
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look for a vestibular schwannoma.
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So let's look on the left side,
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which was the symptomatic side.
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On the left side,
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what we see is the residual of a fracture that went
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across the internal auditory canal and also
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went through and into the cochlea.
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So here is the fracture plane that one sees
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affecting the basal turn of the cochlea.
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This patient, here's the fracture line again,
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that you can see coming across the vestibule,
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look at the lateral semicircular canal.
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You see that it has bony obliteration of
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labyrinthitis ossificans secondary to the fracture,
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which led to a hemo labyrinth,
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blood in the labyrinth.
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So, as opposed to the more normal appearance of the
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lateral semicircular canal on the right side,
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which was not fractured, on the left side,
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we see labyrinthitis ossificans affecting the lateral
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semicircular canal secondary to a previous fracture.
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This patient, by the way,
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also has a soft tissue mass here over the cochlear
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promontory that ended up being an epidermoid.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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