Imaging Findings in Sensorineural Hearing Loss: A Pictorial Essay

Sensorineural hearing loss (SNHL) is a common presenting complaint, particularly in the aging population [1] and can be caused by a wide range of pathologies affecting the cochlea, cranial nerve VIII, and the central auditory pathway. The central auditory pathway includes the bony and membranous labyrinth, the internal auditory canal (IAC), the cerebellopontine angle (CPA), the brain stem, the thalamus, and the temporal lobe. New diagnosis of SNHL is a common reason for requesting cross sectional imaging. Given the wide range of potential pathologies (Table 1), both high resolution computed tomography (CT) and gadolinium enhanced magnetic resonance imaging (MRI) are used in the initial assessment of SNHL although, where available, MRI is commonly used as first-line imaging. Causes of hearing loss that primarily present with conductive or mixed hearing loss such as otosclerosis, cholesteatoma, and temporal bone fracture are not included in the scope of this review. The most common cause of SNHL is presbycusis, affecting more than one-third of adults older than 75 years of age. Presbycusis is caused by age related degenerative changes involving the organ of Corti, which are beyond the resolution of current imaging techniques. Imaging is carried out to assess for alternative, potentially treatable, causes of SNHL. The purpose of this pictorial essay is to review important radiologic features of common and