0:01

This was a patient who had a long-standing history of

0:04

chronic otitis media for which a mastoidectomy was performed.

0:08

When we look at the right side,

0:11

we see that the patient has a canal wall up mastoidectomy

0:17

with a defect in the mastoid air cells.

0:20

However,

0:20

there is still opacification of some

0:22

of these mastoid air cells.

0:24

The middle ear ossicles are identified, and we see

0:30

the incudostapedial joint with the stapes here.

0:34

As we continue scrolling,

0:37

we notice that there is bony obliteration of the lateral

0:42

semicircular canal, and we kind of lose the

0:46

limbs of the superior semicircular canal.

0:49

So if we look at the contralateral side,

0:52

we are identifying the two limbs of the superior

0:56

semicircular canal with the semi arcuate vessel

0:59

coursing between it. On the right side,

1:03

we don't see those limbs of the semicircular canal.

1:06

And in fact,

1:07

the posterior semicircular canal is also missing in this

1:11

individual, as is the lateral semicircular canal,

1:14

where we see bony obliteration or bony ingrowth.

1:19

Note that the cochlea looks pretty good,

1:21

except its basal turn.

1:23

So we have the apical turn, the middle turn,

1:27

and at the basal turn, you have ingrowth of

1:30

bone into the basal turn of the cochlea,

1:32

comparing the right side from the left side.

1:35

So once again,

1:36

this is an example of unilateral labyrinthitis ossificans

1:41

as a complication of chronic otitis media.

1:44

And at some point,

1:45

this chronic otitis media must have created a labyrinthine

1:48

fistula and inflammation that got into the labyrinthine

1:52

structures to account for the labyrinthitis ossificans.

Unilateral Labyrinthine Ossificans

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0:01

This was a patient who had a long-standing history of

0:04

chronic otitis media for which a mastoidectomy was performed.

0:08

When we look at the right side,

0:11

we see that the patient has a canal wall up mastoidectomy

0:17

with a defect in the mastoid air cells.

0:20

However,

0:20

there is still opacification of some

0:22

of these mastoid air cells.

0:24

The middle ear ossicles are identified, and we see

0:30

the incudostapedial joint with the stapes here.

0:34

As we continue scrolling,

0:37

we notice that there is bony obliteration of the lateral

0:42

semicircular canal, and we kind of lose the

0:46

limbs of the superior semicircular canal.

0:49

So if we look at the contralateral side,

0:52

we are identifying the two limbs of the superior

0:56

semicircular canal with the semi arcuate vessel

0:59

coursing between it. On the right side,

1:03

we don't see those limbs of the semicircular canal.

1:06

And in fact,

1:07

the posterior semicircular canal is also missing in this

1:11

individual, as is the lateral semicircular canal,

1:14

where we see bony obliteration or bony ingrowth.

1:19

Note that the cochlea looks pretty good,

1:21

except its basal turn.

1:23

So we have the apical turn, the middle turn,

1:27

and at the basal turn, you have ingrowth of

1:30

bone into the basal turn of the cochlea,

1:32

comparing the right side from the left side.

1:35

So once again,

1:36

this is an example of unilateral labyrinthitis ossificans

1:41

as a complication of chronic otitis media.

1:44

And at some point,

1:45

this chronic otitis media must have created a labyrinthine

1:48

fistula and inflammation that got into the labyrinthine

1:52

structures to account for the labyrinthitis ossificans.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Lesson

Inner Ear

Unilateral Labyrinthine Ossificans