This study aimed to test the accuracy and reliability of cochlear lateral wall length measurements using 3D MR imaging. In doing so, we hope to guide advancement in neurotologic imaging and apprise clinicians of the utility of imaging in peripheral vestibular disease diagnosis.īACKGROUND AND PURPOSE: Prior studies have evaluated cochlear length using CT to select the most suitable cochlear implants and obtain patient-specific anatomy. This review assesses the current state of imaging in the neurotology clinic with a special focus on magnetic resonance imaging and then gathers diseases identified by vestibular testing and histopathological studies that could be better understood with developments in imaging. With these improvements in imaging, clinicians will be able to understand better atypical presentations of peripheral vestibular disorders, disease intractable to traditional therapy, disorders with unclear pathoetiology and disease only seen on histopathological studies. Developments in magnetic resonance imaging are allowing for increased spatial resolution and better image contrast, improving our ability to see soft tissue structures including the membranous labyrinth, sensory epithelia and nerves. However, these “invisible” diagnoses are becoming increasingly visible with advancements in imaging technology. Imaging is rarely a part of diagnostic work up as the pathologies of these disorders are “invisible,” or undetectable on imaging. The majority of these disorders are diagnosed with a detailed history and vestibular physical exam.
Peripheral vestibular disorders are caused by pathology of the inner ear.
In addition, the features at pre- and postprocedural MRI will be discussed to help ensure that diagnostic radiologists may be of greatest use to the ordering physicians. The purpose of this review is to provide an overview of the most useful MRI sequences for internal auditory canal and labyrinthine imaging, review the relevant anatomy, and discuss the expected appearances of the most commonly encountered pathologic entities. Nevertheless, despite the widespread use of MRI for these purposes, many radiologists remain unfamiliar with the complex anatomy and expected imaging findings with such examinations.
It is also extensively used in pre- and postoperative evaluations, particularly in patients with vestibular schwannomas and candidates for cochlear implantation. It is used to evaluate normal anatomic structures, evaluate for vestibular schwannomas, assess for inflammatory and/or infectious processes, and detect residual and/or recurrent cholesteatoma. MRI is firmly established as an essential modality in the imaging of the temporal bone and lateral skull base.
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