Imaging of sensorineural hearing loss: a pattern-based approach to diseases of the inner ear and cerebellopontine angle

An overview is presented of the common and uncommon diseases of the inner ear and of the cochleovestibular nerve within the internal acoustic meatus and cerebellopontine angle cistern causing sensorineural deafness. An imaging-pattern-based approach is used to help detect disease and narrow the differential diagnosis. Main Messages • The most common soft tissue mass lesions in the cerebellopontine angle are schwannoma and meningioma. • Contrast-enhanced MRI may reveal clinically unsuspected inflammatory, auto-immune or tumoural disease. • Hearing loss may be caused by infection, inflammation or, rarely, perineural tumour spread along the cochleovestibular nerve. • Labyrinthitis may lead to rapidly progressive ossification of the labyrinth.