Inflammation of Inner Ear

Labyrinthitis can result from many different etiologies, including viral and bacterial infection of the inner ear, meningitis, autoimmune diseases, and trauma (20). Sensorineural hearing loss and vertigo are common symptoms. On postcontrast T1W images, labyrinthitis can present as diffuse abnormal enhancement of the normally nonenhancing labyrinth (Fig. 134.24). Precontrast T1W mR images are needed to differentiate intra-labyrinthine hemorrhage from labyrinthitis (Fig. 134.25). When acute labyrinthitis proceeds to a chronic stage, fibrous tissue fills the membranous labyrinth. T2W images can demonstrate fibrous replacement of the normally fluid-filled spaces of the labyrinth. Chronic inflammation can also lead to abnormal bone formation within the membranous labyrinthine space, and this condition is referred as labyrinthitis ossificans (21). Severe cases of labyrinthine ossificans must be distinguished from Michel deformity.

FIGURE 134.24. Labyrinthitis. A: Axial T1-weighted magnetic resonance image shows no abnormal signal in the inner ear. B: Axial postcontrast T1-weighted magnetic resonance image shows abnormal enhancement of the cochlea (black arrow) and the vestibule (white arrow), indicating an inflammatory process (i. e., labyrinthitis).

FIGURE 134.25. Hemorrhagic labyrinthitis. Axial Tl-weighted magnetic resonance image demonstrates abnormally increased signal consistent with subacute hemorrhage in the left cochlea and vestibule (open white arrows). The right cochlea and vestibule demonstrate a normal signal pattern. (Courtesy of Dr. Pamela Blake.)

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