imaging of the inner ear, CT and MRI

1. IMAGING of the INNER EAR
M. Mazón
mazonmig@gmail.com
JFIM Barcelona nov 2014

2. Área de Imagen Médica
v
CASO
• Awake
• Overlapping
• Content
Ø Anatomy Review
Ø Pathology
OBJECTIVES

3. Área de Imagen Médica
v
CASO
• Awake
• Overlapping
• Content
Ø Anatomy Review
Ø Pathology
OBJECTIVES

4. Área de Imagen Médica
v
• Awake
• Overlapping
• Content
Ø Anatomy Review
Ø Pathology
OBJECTIVES

5. Área de Imagen Médica
IMAGING TECHNIQUES

6. Área de Imagen Médica
1. ANATOMY REVIEW

7. Área de Imagen Médica
EMBRYOLOGICAL
1. ANATOMY REVIEW
FUNCTIONAL
1. Squamous
2. Mastoid
3. Petrous
4. Tympanic
5. Styloid
1. External Ear
2. Mastoid and ME
3. Facial Nerve
4. Inner Ear
5. IAC
6. Petrous Apex

8. Área de Imagen Médica
1. External Ear
2. Mastoid and ME
3. Facial Nerve
4. Inner Ear
5. IAC
6. Petrous Apex
1. ANATOMY REVIEW
FUNCTIONAL

10. V
V
T
T

16. Área de Imagen Médica
2. PATHOLOGY
• CONGENITAL
• ACQUIRED

17. Role of IMAGING in SNH
(Sensorineural Hearing loss)
• Detection & characterization (30%)
• Surgical map
• VII cranial nerve
• Yugular vein, Carotid artery
• Route of acces
• CI (cochlear implantation)
Ø Cochlear permeability
Ø Cochlear nerve patency
INNER EAR MALFORMATIONS
Más-Estellés, F. Rambla-Vilar, J. Uehara, M. et al. (2011, november). Imaging of
Vestibulocochlear Nerve Deficiency: Impact on Cochlear Implantation. Educational
Exhibit, RSNA Anual Meeting, Chicago. USA

18. LABYRINTHINE APLASIA
*
*
*
3 w

20. COCHLEAR APLASIA
*
*
* * 1 2
2
3 w

21. COMMON CAVITY
Vs
4 w

22. INCOMPLETE PARTITION Type I 5 w

23. INCOMPLETE PARTITION Type II 7 w

24. INCOMPLETE PARTITION Type III

25. COCHLEAR HYPOPLASIA

26. LARGE VESTIBULAR AQUEDUCT SYNDROME

27. VESTIBULOCOCHLEAR NERVE DEFICIENCY

28. MALFORMATIONS of the VESTIBULE & SCC
*

29. SEMICIRCULAR CANAL DEHISCENCE

30. • Labyrinthine Aplasia
• Cochlear Aplasia
• Common Cavity
• IP - I
• IP - II
• IP - III
INNER EAR MALFORMATIONS
• Cochlear Hypoplasia
• Large Vestibular Acqueduct S.
• Vestibulocochlear N. Deficiency
• Malformations Vestibule & SCC
• SCC Dehiscence
ANALYZE > memorize

31. ACQUIRED PATHOLOGY
• Otospongiosis
• Labyrinthitis
• Labyrinthine hemorrage
• Menière’s Disease
• Intralabyrinthine Schwannoma
• Endolymphatic Sac Tumor

32. OTOSPONGIOSIS
2
1b V. 1a F. Veillon 2 V.
3 V. 4 V.

33. LABYRINTHITIS Acute

34. LABYRINTHITIS Fibrous

35. LABYRINTHITIS Ossificans

36. LABYRINTHITIS
Labyrinthitis ossificans vs Aplasia

37. LABYRINTHINE HEMORRAGE

38. MENIÈRE’S DISEASE
Baráth K, Schuknecht B, Naldi AM et al. Detection and grading of endolymphatic hydrops in Menière disease using MR imaging. AJNR Am J Neuroradiol. 2014 Jul;35(7):1387-92

39. MENIÈRE’S DISEASE

40. INTRALABYRINTHINE SCHWANNOMA

41. ENDOLYMPHATIC SAC TUMOR

42. Área de Imagen Médica
D I: Head & Neck, Hansberger et al. 2nd EdiRon, 2010 M. Mazón, based on Senarouglu, 2014 otopathologynetwork.org
Acknowledgments:
• E. Pont, F. Mas-Estellés, F. Menor, P. Montesinos, M. A. Sánchez
• Division of Neuroradiology & R. Head & Neck
• Your attention.