Neuroimaging clinics of North America
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Temporal bone high-resolution computed tomography (HRCT) and magnetic resonance (MR) imaging are valuable tools in the evaluation of pediatric hearing loss. Computed tomography is important in the evaluation of pediatric conductive hearing loss and is the imaging modality of choice for evaluation of osseous abnormalities. ⋯ A broad spectrum of imaging findings can be seen with hearing loss in children. HRCT and MR imaging provide complementary information and are often used in conjunction in the preoperative evaluation of pediatric candidates for cochlear implantation.
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Temporal bone pathologies are challenging to discern because of their small size and subtle contrast. MR imaging is one of the key modalities in evaluating otologic diseases. Current advancement in MR techniques provide multiparametric information for evaluation of these pathologies. The aim of this article is to review state-of-the-art 3-dimensional morphologic and diffusion sequences for otologic MR imaging.
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In their variety, temporal bone tumors mirror the complexity of the structure from which they arise. They include more familiar lesions, such as vestibular schwannomas and paragangliomas, and also rarer neoplasms, such as nonvestibular schwannomas, sarcomas, giant cell tumors, Schneiderian papillomas, and endolymphatic sac tumors. ⋯ The ability to differentiate tumors from benign ('don't touch') or indolent lesions can prevent unnecessary morbidity. This article reviews a range of temporal bone neoplasms, focusing on imaging approaches and characteristic imaging findings.
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Third window abnormalities are bony defects of the inner ear that enable abnormal communication with the middle ear and/or cranial cavity. Vestibular symptoms include vertigo and nystagmus induced by loud noises or increases in pressure. ⋯ High-resolution temporal bone computed tomography is the first-line imaging modality for evaluation of third window pathology and is critical for accurate diagnosis and management. This article reviews the fundamental mechanisms of the third window phenomenon and describes imaging findings and differential diagnosis.
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Although not all patients with tinnitus require imaging, patients with tinnitus and asymmetric hearing loss, additional neurologic findings, or pulsatile tinnitus should be evaluated with an appropriately tailored imaging study. Choice of imaging study should be guided by type of hearing loss and additional physical examination findings, such as middle ear lesion, presence of carotid bruit, or pulsatile tinnitus extinguished by jugular compression.