Neuroradiology of vestibular pathways

Comprehensive efficacious neuroimaging of the vestibular pathways requires cooperation and coordinated efforts between the otologist and the neuroradiologist to avoid duplication of expensive and sometimes invasive study. For peripheral lesions, for example, those of the labyrinthine organ, thin-section CT is optimum as a first examination. For retrolabyrinthine lesions along nerve tracts or in the central pathway, MRI is preferred. When bone erosion occurs, CT can also be helpful in evaluation of the base of the skull to detect and define the extent of these lesions, for example, cholesterol granuloma and glomus tumor.