Progressive bilateral hearing loss. History of T2DM, coronary artery disease and hypertension. Status post renal and heart transplant in 2009. The bilateral cranial nerve 7 and 8 complexes are intact and show no abnormal contrast enhancement or mass lesion. Other than for apparent asymmetric thinning of the bony coverage over the apex of the left superior semicircular canal which likely remains within normal limits, the inner ear structures, including the cochlea, vestibule, endolymphatic duct, and semicircular canals, appear unremarkable. The bilateral mastoid air cells and middle ears also appear unremarkable.Included brain is notable for chronic left thalamic lacunar infarcts in addition to multiple of T2-hyperintensity in the brain and brainstem which are nonspecific but likely represent small vessel ischemia. There is also mild-to-moderate cerebellar volume loss. There is mild mucosal thickening in the paranasal sinuses.
No evidence of retrocochlear or inner ear lesions to account for sensorineural hearing loss.