Magnetic Resonance Imaging-Enhancing Lesions of the Labyrinth and Facial Nerve: Clinical Correlation

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Abstract
Objective: Gadolinium-enhanced magnetic resonance imaging (MRI) is useful in assessing inflammatory and neoplastic lesions of the labyrinth and facial nerve. The following cases demonstrate the ability of MRI to differentiate neoplastic from inflammatory lesions within the labyrinth. Patients or Other Participants: Nine patients were selected with enhancing lesions of the labyrinth and the facial nerve identified on MRI. Intervention: Acyclovir and prednisone were prescribed for herpes zoster oticus; surgical removal of neoplastic lesions was performed. Main Outcome Measure: The hypothesis was developed in the course of clinical practice. No planned outcome was emphasized, as this article is based on the differential diagnoses of the cases reported. Results: Gadolinium-enhanced MRI is useful in differentiating neoplastic from inflammatory lesions within the labyrinth. Axial and coronal 3-mm sections with gadolinium enhancement were necessary for identifying these lesions and particularly for recognizing the sharp enhancement of the neoplastic margin in contrast to the dull cloudy margins of an inflammatory lesion. Conclusions: The MRI differentiation of these lesions is helpful in providing appropriate medical and surgical management of neoplastic and inflammatory lesions of the labyrinth. (Arch Otolaryngol Head Neck Surg. 1994;120:560-564)