Abstract
Tinnitus and hearing loss in the adult can have profound effects on the quality of life. The imaging workup for tinnitus and hearing loss in adults follows otoscopic exam and audiometry testing. CT and MR imaging have different and often complementary roles in the evaluation of tinnitus and hearing loss depending on the clinical scenario and the suspected underlying cause. Imaging can often identify the cause and evaluate the extent of disease for surgical planning. This article discusses anatomy, imaging technique, and diseases that cause tinnitus and hearing loss with a mass and without a mass.
Highlights
Evaluation of tinnitus starts with otoscopic examination to determine if there is a vascular retro-tympanic mass, audiometric examination, and review of medical history and medications
Labyrinthitis ossificans is the late stage of labyrinthitis, in which there is pathologic ossification of spaces within the membranous labyrinth
Asymptomatic defects are rare (2% of the population) so further audiometric evaluation is recommended for all patients with imaging findings [3]
Summary
Key Points • Imaging can identify the cause and evaluate the extent of disease for surgical planning. • The common causes of tinnitus and hearing loss without a mass include otospongiosis, labyrinthitis ossificans, superior semicircular canal dehiscence, and enlarged vestibular aqueduct syndrome. • Otospongiosis affects the bony labyrinth, while labyrinthitis ossificans affects the membranous labyrinth. • Vestibular schwannomas often present with nonpulsatile tinnitus and high frequency sensorineural hearing loss.
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