Evaluation of labyrinthine fistula by MR cisternography

Abstract

Sensorineural hearing loss (SNHL) can develop after trauma and determination of its etiology is crucial for treatment planning. Computed tomography (CT) is the first-line imaging method in evaluation of trauma victims; however, its value is limited in visualization of perilymphatic fistula or in assessment of cochlear implant candidates. Herein, we present imaging findings of a patient with traumatic bilateral transverse fractures of temporal bones and resultant SNHL. This patient had a fistula between inner ear and subarachnoid space which was detected at non-contrast-enhanced MR cisternography (NCE-MRC) and contrast-enhanced MR cisternography (CE-MRC) scans. To the best of our knowledge, this is the first case in the literature. In conclusion, in patients with transverse fractures of temporal bone, in presence of otic capsule involvement at CT images, the inner ear structures and surrounding organs should be carefully evaluated via NCE-MRC. In case of a suspicion of a fistula, CE-MRC can help in early diagnosis and can also help to visualize the leakage location, which is of paramount importance for correct treatment and management of such cases.