Inner ear MRI

MRI of the inner ear

MRI of the inner ear is a medical examination that enables precise visualization of the auditory nerves, facial nerve, inner ear structures and blood vessels.

This examination can be used to assess vertigo, headaches, tinnitus or hearing disorders. Thanks to this examination, the radiologist is able to detect lesions on the hearing nerve pathways, vascular loops or malformations of inner ear structures.

Inner ear pain?

The ear has a three-part structure. The outer ear is the part you see and your ear canal. The middle ear is a box-like area behind the tympanic membrane (the eardrum) that comprises the three smallest bones in your body. The inner ear or labyrinth lies just beyond the middle ear, in a small hole in the temporal bones that make up the sides of your skull.

The inner ear is a small part of the base of the skull. Your inner ear has two main functions: to enable you to hear, and to help you keep your balance. Pain in the inner ear can therefore be responsible for dizziness, a feeling of imbalance and rotation of the environment or your own body.

Vertigo is a frequent symptom in medical consultations, and in some cases requires treatment.  

Why have an inner ear MRI?

MRI can be used to explore the main abnormalities, particularly tumors such as vestibular schwannoma, a rare tumor that can cause vertigo of all types.

There are two main emergency situations:

• suspected stroke
• recurrent vertigo for which the clinical stage has failed to identify the cause 
• MRI is particularly effective for vestibular neuritis and Menière's disease. In addition, MRI is playing an increasingly important role in the detection of inner ear malformations.

What causes vertigo?

Vertigo occurs when the body's perception of its position in space is disturbed. It can come and go, recur and last for weeks or months. Neurological disorders associated with vertigo are particularly serious forms. Any sudden onset of vertigo associated with neck pain, visual disturbances, or limb or facial mobility problems should be the first port of call for an emergency consultation.

The most common causes of vertigo are disorders of the inner ear. Here are a few common causes:

• Benign Positional Paroxysmal Vertigo (BPPV) is a very short, relatively mild vertigo attack lasting a few seconds and triggered by changes in position. BPPV occurs when calcium crystals in the inner ear - which help control balance - are dislodged from their normal position and move elsewhere in the inner ear. BPPV is the most common cause of vertigo in adults. You may experience a spinning sensation when you turn in bed or tilt your head back to look up.
• Acute Vestibular Deficit is another major cause. This is a drastic reduction in inner-ear function, which may or may not be associated with hearing loss. It provokes a severe vertigo attack with permanent environmental rotation.
• Menière's disease and related syndromes (endolymphatic hydrops), characterized by recurrent episodes, is responsible for attacks of vertigo lasting several hours, associated with deafness or unilateral tinnitus. In addition to sudden and severe vertigo, Ménière's disease can cause fluctuating hearing loss and ringing, buzzing or fullness in the ear. The cause of Menière's disease is still a matter of debate among doctors. Menière's disease is not very common, affecting mainly people between the ages of 20 and 40.
• Migraine is a very frequent source of dizziness. Dizziness and sensitivity to movement (vestibular migraine) may be due to migraine.
• Vestibular neuritis; This inflammatory disorder, thought to be caused by a virus, can affect the nerves in the part of the inner ear responsible for balance. As a result, symptoms can worsen, including nausea and difficulty walking.
• Persistent postural-perceptual vertigo; Symptoms are characterized by an unsteadiness or spinning sensation in the head. Symptoms often worsen when watching moving objects, reading or being in a visually complex environment such as a shopping mall. This is the third most common disorder in adults.
• Acoustic neuroma. This slow-growing, non-cancerous (benign) tumor develops on a nerve that affects your hearing and balance. You may experience dizziness or loss of balance, but the most common symptoms are hearing loss and ringing in the ear. Acoustic neuroma is a rare condition.
• Ramsay-Hunt syndrome. Also known as herpes zoster oticus, this condition occurs when a shingles-like infection affects the facial, auditory and vestibular nerves near one of your ears. You may experience dizziness, ear pain, facial weakness and hearing loss.
• Head injury. You may experience dizziness following a concussion or other head injury.
• Motion sickness. You may feel dizzy on a boat, in a car or plane, or in an amusement park.