Progressive conductive hearing loss.
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There is bilateral left greater than right fenestral and cochlear otospongiosis as manifested by arc like hypo hypodensities starting at the fissula ante fenestram and surrounding the cochlea and vestibule, extending into the anterior wall of the internal auditory canals.
This is an advanced case of otosclerosis. There is involvement of fissula ante fenestram, oval window, round window and the otic capsules. The left side is showing both fenestral and cochlear otosclerosis.
Otosclerosis is a disease of bony labyrinth. It starts at the fissula ante fenestram and spreads posteriorly to involve oval window and then is called the fenestral type.
If it progresses it will involve the round window, pericochlear region and the otic capsule and then it is called the cochlear type.
This case is very advanced because the lucencies surrounding the otic capsule, and spreading to the anterior wall of the IACs. There is also bony overgrowth of the basal turn of the cochlea obliterating the round window niche.
- 1. Davidson HC. Imaging of the temporal bone. Magn Reson Imaging Clin N Am. 2003;10 (4): 573-613, v. Pubmed citation
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