Magnetic resonance imaging for evaluation of otic labyrinth pathology

The auditory (cochlear) labyrinth, the cochlea, holds the hearing sensory receptors. The vestibular labyrinth contains the sensory receptors for balance, which lie in the three semicircular canals and in the otolithic organs (the saccule and utricle). Pure tone audiometry and brain stem evoked audiometry can help to differentiate a peripheral cochlear disorder from central lesion. The type of nystagmus, severity of postural instability, and neurological evaluation can help to differentiate a peripheral vestibular disorder from a central vestibular lesion. The decision whether to perform an appropriate imaging such as brain imaging versus labyrinthine imaging depends on the clinical and paraclinical information provided to the radiologist by the neurotologist, neurologist, or other clinicians. The magnetic resonance imaging characteristics of peripheral cochlear and vestibular lesions are the main focus of this article.