A 15 year old boy presented with vertigo and hearing loss. He was treated for bacterial meningitis during his childhood..

1. What is the diagnosis?

2. What is the classic history?

3. This condition has what surgical implication?

Correct answer:

1. What is the diagnosis?

 Labyrinthine Ossificans

2. What is the classic history?

 Childhood meningitis

3. This condition has what surgical implication?

May complicate or preclude cochlear implantation

Labyrinthine Ossificans

Fibroblasts from prior infection (or inflammation) lead to a pathologic ossification of the normally fluid filled spaces of the bony labyrinth.

KEY FEATURES

- Bacterial meningitis is the most common acquired cause

- Usually associated with severe sensorineural hearing loss . 

-The other major symptom with this is vertigo (this is one of the “dead ear” vertigo causes).

- The earliest changes are typically seen in the basal turn of the cochlea and scala tympani

- Osseous destruction at the round window niche makes placement of the cochlear implant difficult (the further into the cochlear turns you can put the electrode the better they do).

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