Clinical Problem Solving: Radiology |

Radiology Quiz Case 1

Shraddha S. Mukerji, MD; Hemant A. Parmar, MD; Melissa A. Pynnonen, MD
Arch Otolaryngol Head Neck Surg. 2007;133(3):298. doi:10.1001/archotol.133.3.298.
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A 6-year-old girl presented with bilateral progressive hearing loss 1 month after being successfully treated for bacterial meningitis. There was no history suggestive of vertigo, tinnitus, otorrhea, or ear trauma. Her family history was not contributory. Ear, nose, and throat examinations did not reveal any abnormality except bilateral sensorineural deafness. Neurologic and systemic findings were normal. An audiogram confirmed bilateral severe sensorineural deafness (the hearing loss was greater in the left ear than in the right ear). Coronal T2-weighted images through the membranous labyrinth showed a decrease in the T2 signal (Figure 1, arrows) bilaterally. The decrease was more marked in the basal turn of the left cochlea (Figure 2, arrowheads). A coronal contrast-enhanced T1-weighted image showed inflammatory enhancement in the membranous labyrinths (Figure 3, arrows) bilaterally, but the enhancement was more marked in the basal turn of the left cochlea. There was some enhancement in the left middle ear cavity as well.

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