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Infectious labyrinthitis

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Flu 2 months previously. Since then, worsening sensorineural hearing loss in the left ear.

Patient Data

Age: 75
Gender: Male
mri

Diffusion restriction, enhancement, and T2 hypointense signal within the left cochlear aperture, basal turn of the cochlea, and vestibule and semicircular canals. Mastoid effusion with enhancement.

Impression:

Abnormal signal and enhancement in the left membranous labyrinth. In the context of subacute hearing loss and with bilateral mastoiditis, these findings are most suggestive of infectious labyrinthitis. Loss of normal T2 signal in the membranous labyrinth suggests the early fibrosis of labyrinthitis ossificans. CT of the temporal bone without contrast is suggested for further evaluation. 

Annotated image

Annotated key findings.

Case Discussion

Typical appearance of infectious labyrinthitis with possible developing labyrinthitis ossificans. Follow-up CT of the temporal bones was normal and without findings of ossification of the left membranous labyrinth.

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