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Case of the Week 6 2016

*5-year-old girl with hearing loss.

What is the most likely diagnosis?

Answer

Answer: Bilateral incomplete partition Type I (cystic cochleovestibular anomaly)

Case Discussion:

Axial MR and CT images show the cystic bilateral cochlea (red arrow) and the dilated cystic bilateral vestibule (yellow arrow). The vestibular aqueduct is normal in size.

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Cochlear anomalies can be divided as follows:
• complete labyrinthine aplasia (Michel deformity), 3rd week
• cochlear aplasia, 4th week
• common cavity to the cochlea and vestibule, early 5th week
• incomplete partition type I (cystic cochleovestibular anomaly), late 5th week
• cochlear hypoplasia
• incomplete partition type II including Mondini dysplasia ,7th week

References:
1. Head and neck imaging. Ed. by Peter M. Som, Hugh D. Curtin. St Louis (Mo.) : Mosby-Year Book, 2003.
2. Jackler RK, Luxford WM, House WF. Congenital malformations of the inner ear: a classification based on embryogenesis. Laryngoscope. 1987;97 (3 Pt 2 Suppl 40): 2-14.
3. Sennaroglu L, Saatci I. A new classification for cochleovestibular malformations. Laryngoscope. 2002;112 (12): 2230-41.