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45 year old with chronic bilateral hearing loss for cochlear implant assessment

45 year old with chronic bilateral hearing loss for cochlear implant assessment

CT axial noncontrast bone windows

CT coronal reconstructions noncontrast bone windows

T2 axials


Findings:

CT: Subtle demineralization surrounding both the right and left cochlea, worse on the right side MRI: Increased T2 signal surrounding the cochlea bilaterally

DDX:

Cochlear otosclerosis


Diagnosis:

Cochlear otosclerosis

Discussion:

Cochlear otosclerosis is an uncommon cause of mixed and sensorineural hearing loss. It has a characteristic appearance on CT, producing a distinctive pericochlear hypodense double ring. However, its appearance on MRI is not as readily appreciated, producing a ring of intermediate signal in the pericochlear and perilabyrinthine regions on T2 and T1 weighted images sometimes with enhancement.


Submitted by Hari Challa, MD, UW Neuroradiology Fellow