Otalgia/sensorineural hearing loss, bilateral. The optic nerves are mildly abnormal in appearance and small crowded in constitution most consistent with a diagnosis of "pseudopapilledema." There is possible deficiency of bone overlying the bilateral superior semicircular canals. The bilateral cranial nerve 7 and 8 complexes are intact. There is no evidence of mass lesions. The cochleas, vestibules, and endolymphatic ducts appear unremarkable. The bilateral mastoid air cells and middle ears also appear unremarkable. There is a pineal gland cyst that measures up to 9 mm. There is a prominent retrocerebellar cerebrospinal fluid space. There is mild concavity of the superior aspect of the pituitary gland. There are partially-imaged borderline prominent upper cervical lymph nodes.
1. Possible deficiency of bone overlying the bilateral superior semicircular canals. A temporal bone CT may be useful for further evaluation of dehiscence if clinically warranted. 2. A pineal gland cyst measures up to 9 mm, which likely represent benign cystic degeneration, although incompletely characterized in this exam. 3. Nonspecific mild concavity of the superior aspect of the pituitary gland, which could represent a manifestation of pseudotumor cerebri in the appropriate clinical setting.4. Nonspecific partially-imaged borderline prominent upper cervical lymph nodes.