Petrous bone trauma - fracture, ossicular dislocation and labyrinthitis ossificans

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Motor car accident 8 months ago with bilateral progressive hearing loss afterwards.

Patient Data

Age: 50-year-old
Gender: Male

On the axial T2 WI FIESTA images there is loss of bright fluid signal of the left lateral, posterior and apical portion of the superior semicircular canals as well as the basal turn of the left cochlea.

  • On the right side: There is an oblique fracture line traversing the right petrous bone involving the right lateral and posterior semicircular canals and the vestibule and the tympanic portion of the bony facial canal.
    • Incudomalleolar dislocation on the right side.
  • On the left side: There is ossification of the lateral, posterior and superior semicircular canals as well as the basal turn of the cochlea.

    Case Discussion

    Labyrinthitis ossificans, also known as labyrinthine ossification, represents pathologic ossification of the membranous labyrinth as a response to an insult to the inner ear.

    It most commonly results from an inflammatory process of the inner ear, but it can be associated with temporal bone trauma, temporal bones tumors or autoimmune inner ear disease.

    It is usually associated with profound sensorineural hearing loss, and it may complicate or preclude cochlear implantation.

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