Asymmetry of the internal auditory canals without acoustic neuroma

During the past five years, nine patients with "significant" unilateral enlargement of one internal auditory canal by polytomography were subsequently found to have freely filling canals on contrast posterior fossa myelography. The radiographic appearance of the enlarged canals varied greatly and included all the various configurations usually suggestive of acoustic neuroma. Likewise, the clinical presentation varied greatly from asymptomatic to highly suggesting of cerebellopontine angle tumor. This series underscores the essential nature of posterior fossa studies in the evaluation of potential acoustic neuromas and the variability of the normal architecture of the internal auditory meatus.