Assess for possible retrocochlear pathology: asymmetric high frequency sensorineural hearing loss and right sided tinnitus. The bilateral cranial nerve 7 and 8 complexes are intact. There is no evidence of mass lesions. 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. The left Meckel cave is asymmetrically prominent and there is slight protrusion of cerebrospinal fluid through the left foramen ovale. There is a partially-empty sella. There is mucosal thickening and secretory disease in the left maxillary sinus.
1. No evidence of retrocochlear or inner ear lesions, although the assessment is limited without intravenous contrast.2. The left Meckel cave is asymmetrically prominent and there is slight protrusion of cerebrospinal fluid through the left foramen ovale, which may represent a small meningocele. In addition, there is a partially-empty sella. The constellation of findings may indicate pseudotumor cerebri.3. Findings suggestive of acute left maxillary sinusitis.