Abstract
We noted enlargement of the internal auditory canal in several of our patients with posterior fossa malformations, hemangiomas, arterial anomalies, cardiac defects, eye abnormalities, and sternal or supraumbilical defects (PHACES) association and hence evaluated children with PHACES for the presence of an enlarged internal auditory canal and potential associated findings, including infantile hemangioma within the internal auditory canal, to understand the genesis of this enlargement. We reviewed our records to identify children with PHACES association who had been evaluated with MR imaging at our institutions. Imaging was reviewed for abnormal enhancement in the internal auditory canal, internal auditory canal enlargement, cerebellar hypoplasia, prominence of the petrous ridge, and deformity of the calvarium. We raise the possibility of an association between enlargement of the internal auditory canal in PHACES and a generalized malformation of the posterior fossa with cerebellar and calvarial hypoplasia.
Highlights
Approximately 36% of the pediatric patients with enlarged internal auditory canal (IAC) imaged with contrast-enhanced MR imaging during the first 3 years of life had abnormal IAC enhancement indicating the presence of an ipsilateral IAC hemangioma
The demonstration of unilateral cerebellar hypoplasia with ipsilateral funnel-shaped IAC enlargement later in childhood or in adulthood may be helpful in suggesting a diagnosis of PHACES association
We demonstrate a high incidence of funnel-shaped IAC enlargement in patients with PHACES association, and many of these patients were found to have hemangiomas within the enlarged
Summary
36% of the pediatric patients with enlarged IACs imaged with contrast-enhanced MR imaging during the first 3 years of life had abnormal IAC enhancement indicating the presence of an ipsilateral IAC hemangioma. The percentage increased to 70% of patients when imaging was performed during the first year of life
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