Dr. Vivek Chail
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hi doctor,
I have attached the head CT scan with contrast from two years ago. I previously had normal inner ear and brain MRIs back in ten years ago for left ear single-sided progressive hearing loss with tinnitus. All scans have come back to normal. For this CT scan I am showing, can you comment on the semicircular canal system for dehiscence or thinning and the bony otic capsule to observe any third window that includes a dilated vestibular aqueduct, perilymph fistula, carotid, or facial canal dehiscences? Kindly provide your insight.
Hi,
Welcome to icliniq.com.
I thoroughly read your query and understand your concern.
I hope you are not in much discomfort. I have reviewed the reports (attachments are removed to protect the patient's identity). The semicircular canal system on the left side is normal. The superior semicircular canal is not dehiscent, and there is no third window in the images. There is no dilated vestibular aqueduct. There are normal carotid and facial nerve canals on the left side. There is no perilymph fistula.
I hope this helps.
Revert in case of queries.
Regards.
Patient's Query
Hi doctor,
Thank you so much.
From what I understand, the images provided for this did not include 0.6 mm cuts or less in the Stenver and Poschl view. Is that correct? Do you think the images provided were adequate with regards to the initial question I was asking you to have checked and responded to? After asking for comments on the things that I mentioned in my original question, the specialist did put this note at the end of his letter to the radiologist, "I leave it to your discretion as to whether the CT might need to be repeated at 0.6 mm cuts or less in the Stenver and Poschl views". Were the CT images provided in my original question enough to exclude carotid artery-cochlear dehiscence? This one has scared me as apparently it can be fatal.
Hello,
Welcome back to icliniq.com.
I understand your query and concern.
The images (attachments are removed to protect the patient's identity) shared previously are 3 mm and 1 mm in slice thickness. This thickness is sufficient to view the structures in most parts of temporal bones. However, some clinicians prefer 0.6 mm images at times. The Poschl and Stenvers views are machine-created oblique sections of images, and this is the post-processing of images obtained in axial sections. Your doctors have requested a try at repeating 0.6 mm images and then re-constructing in the Poschl and Stenvers view to get a better visualization of the temporal bone structures. CT images done previously show the carotid and cochlear separation. There are no features of carotid cochlear dehiscence in your images (attachments are removed to protect the patient's identity).
I hope this helps.
Revert in case of queries.
Regards.
Patient's Query
Hi doctor,
Thanks again.
I will leave out having another CT because it is not cheap to do it privately in my place, and if the images provided are sufficient to have shown the answers to the original question I asked here as well as rule out carotid cochlear dehiscence, then I am happy to leave it. Would you agree? The CT report states that the impression is a normal CT scan, and I saw your comments. This means you are also stating that the scan is normal. Is that correct? I have also had normal MRI scans in previous years of the brain or internal auditory meatus that have come back as normal (in relation to my single-sided deafness). I have had possible explanations for the reasons, but most specialists seem to say by this point, it is idiopathic. This is after a list of scans, blood tests, and relevant tests are done, etc. Are you happy with my decision not to pursue another CT scan, as what I have provided for you is adequate? "CT images done previously show the carotid and cochlear separation. There are no features of carotid cochlear dehiscence in your images." This statement you just said basically rules out carotid cochlear dehiscence from the CT images I have provided in the original question. Is that right? Were the images provided in the original question adequate enough for you?
Hi,
Welcome back to icliniq.com.
I thoroughly read your query and understand your concern.
I affirm your decision not to have another CT (computed tomography) scan, as the one done is showing normal findings. There are causes that are not always visualized in images (attachments are removed to protect the patient's identity). There is the possibility of nerve-related deafness that might be the outcome of infections or taking medications. However, in a few patients, it is not possible to single out the cause of nerve deafness. The images you have provided are adequate for an assessment of the temporal bone and to evaluate for possible causes of your deafness. There is no carotid cochlear dehiscence in the given images.
I hope this helps.
Revert in case of queries.
Regards.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
General Practitioner
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
